Building Bridges: Conversations Around Brain Injury and Community Support

By Christy Coenen Coordinator, Membership & Events

Over the past several months, I’ve had the opportunity to collaborate with a dedicated group of professionals to help educate and support our community around brain injuries. This work has opened doors to meaningful partnerships with a wide range of organizations—from homeless shelters to AODA (alcohol and other drug abuse) programs—and has highlighted the power of cross-sector collaboration.

Together, we’ve been able to step into various agencies and offer practical training on how to recognize the signs of a brain injury, how to assess those signs, and most importantly, how to guide individuals to the right services. These conversations are not always easy, but they are essential. They create a shared language among service providers and a clearer path forward for those who need support.

Equally impactful has been the time spent with individuals affected by brain injury. Through support groups, we’ve created space for people to share how they came to understand their injury, the ways they manage daily challenges, and how they lift each other up through mutual support and education. These stories are raw and powerful. They remind us that healing doesn’t happen in isolation—it happens in community.

When It Clicked: Volunteer Passion Meets ATSA’s Purpose

A few months into this work, I had a moment where it all clicked. I began to see just how closely my passion project—working with individuals affected by brain injury—was aligned with the mission we uphold at ATSA.

As I listened to individuals describe their experiences—how they learned about their injury, how it changed their relationships and behaviors, and how it affected their sense of control—it hit me: this isn’t separate from our work at ATSA. In fact, it’s central to it.

ATSA Member's talk about rehabilitation, risk reduction, accountability, and ethical care. What if part of what we call resistance or poor insight is actually rooted in undiagnosed cognitive injury? What if a person’s failure to follow through isn’t willful, but neurological?

This perspective shift matters. Recognizing and addressing brain injuries can be a gateway to more effective intervention, stronger rapport, and better outcomes. It’s not just about screening—it’s about humanizing.

What the Research Reveals

Recent studies make it clear that brain injuries are not a marginal issue in our field—they are common, often overlooked, and deeply relevant:

• Nearly 50% of a sample of 476 adult males who caused sexual harm assessed at a psychiatric hospital had experienced head injuries resulting in loss of consciousness. About 22.5% had significant neurological impact.
  (Langevin, 2006)
• A meta-analysis found that 60% of justice-involved individuals reported a history of traumatic brain injury (TBI), with 53%–75% in male populations specifically. About 52% had experienced TBI with loss of consciousness.
  (Kirk-Provencher, 2020)
• Among young individuals who committed violent offences, 77.5% reported at least one TBI, often linked to aggression and substance use. Many recognized their injury as a turning point toward risky behavior.
  (Katzin, 2020)
• A clinical review found that 6.5% of men with a history of TBI went on to commit sexual offenses post-injury—even without prior history or alcohol involvement—suggesting a neurological role in some offenses.
  (Simpson, 1999)

These numbers are hard to ignore. In comparison, estimates of TBI in the general population range from 12–20%. That means people involved in the justice system—and particularly those convicted of sexual offenses—are several times more likely to have experienced a brain injury.

This Reinforces ATSA’s Values

The more we understand the role of brain injury in behavioral health, the more responsible and effective we become in our work. This includes:

• Recognition before reaction: Behaviors that seem resistant, erratic, or impulsive may stem from brain injury—not defiance or disregard. With screening and education, we can respond appropriately.
• Training across disciplines: Whether you’re in probation, treatment, reentry, or case management, knowing how to spot signs of a brain injury opens up new ways to support individuals—ways that are more just, humane, and effective.
• Community-based support: The support groups I’ve been part of show how powerful it is when people share their stories, learn together, and begin to understand themselves. This mirrors ATSA’s vision of trauma-informed, person-centered care.
• Bringing more voices to the table: We’re stronger when we collaborate. When probation officers, social workers, clinicians, family members, and clients are in dialogue together, we create richer, more supportive systems.

A Call to Action

If you work with individuals—particularly justice-involved clients—ask yourself:

• Have we talked about cognitive or neurological history?
• Have we screened for traumatic brain injury?
• Do we understand how symptoms like memory loss, executive dysfunction, or emotional volatility might be showing up?

If not, now is the time to start. You don’t have to be a specialist to make a difference. There are practical tools, trainings, and partners in your community who can help.

And don’t have these conversations alone. Bring others in—colleagues, treatment team members, community partners. Because the more voices we bring into these conversations, the more effective and compassionate our work becomes.

Brain injuries don’t define a person—but they can shape their journey. And if we don’t talk about them, we miss a crucial part of the picture.

By recognizing brain injuries, we’re not excusing harm—we’re doing what ATSA has always stood for: looking deeper, asking better questions, and creating conditions for accountability, safety, and support.

Let’s keep building those bridges—together.

 

Beyond the Verdict: Why ATSA's Commitment to Prevention and Accountability Matters

by Amber Schroeder, ATSA Executive Director

A few weeks ago, while I was on vacation, I found myself sitting at a car dealership waiting for an oil change, when the Diddy verdict hit the news. I was outraged—not just by the verdict itself but also because of the glaring, persistent societal misperceptions about sexual harm that led to not guilty verdicts on the more serious charges. Again, a moment that should have highlighted the experience of survivors was reduced to a media spectacle.

Like I’m sure many of you did as well, I felt a deep frustration. As I sat there, I texted with one of ATSA’s Board members from that waiting room, and we found ourselves asking the same question: where is the public understanding of what sexual harm actually is? Where is the conversation about prevention, about power, about the possibility of change? As I drove away, one thought kept rising to the surface:

My very favorite thing about ATSA members is that they fundamentally believe in change.

ATSA members hold a core belief that those who cause sexual harm can take responsibility for their actions. They can grow, be accountable, and help create a safer future. We believe that punishment alone doesn't cut it—healing, accountability, and prevention all need to work together. This belief is what makes our field stand out.

 
And now, it’s time for ATSA to live that belief as an organization.

For too long, ATSA has been a strong voice within the professional community—but a quiet one in the public square. When stories like the Diddy case break, we know the public is paying attention. But too often, our expertise, our members' real-world experience, and our research-based understanding of sexual harm go unheard. Not because we don’t have something to say—but because we haven’t had the structure or strategy to say it boldly, clearly, and in real time.

That’s why our 2024–2027 Strategic Plan matters so much.

This plan isn’t just a roadmap for internal improvement—it’s a call to step forward. It lays out our commitment to:

• Strengthen and grow our professional community;
• Expand and modernize educational opportunities;
• Deepen our support for research and evidence-informed practice;
• Influence public policy with clarity, courage, and credibility;
• And critically, reshape how society understands those who cause sexual harm.

As part of this transformation, we’re shifting from a grassroots, volunteer-led model to a professionalized association with the infrastructure to lead. That kind of change comes with growing pains. We’ve had missteps—communications that didn’t land, transitions that felt unclear. But just as we support our clients through moments of uncertainty, we are holding ourselves to that same process.
We are learning. We are listening. And we are committed to transparency.

This is a crucial moment—conversations about sexual harm are happening, but they're missing the nuance that’s so badly needed. It demands that we speak up. That we advocate for an approach rooted in evidence and compassion. That we model the very thing we believe in: the power of meaningful, lasting change.

To our members: thank you. Your unwavering dedication to this work inspires the direction we’re taking. And as ATSA invests in the broader societal conversation, we do so with the fundamental belief that sexual violence can be prevented because of your work.

We are not just responding to change. We are becoming the change.

Framing Prevention Through an Anti-Memetic Lens

by Aniss Benelmouffok

In Antimemetics: Why Some Ideas Resist Spreading, Nadia Asparouhova explores why cultural ideas fail to spread. Much of the resistance to spreading, “immunity” as Asparouhova puts it, is due to the uncomfortable nature of antimemetic subjects.  Reading the book, I couldn't help but see efforts to prevent sexual abuse through an antimemetic lens.

To frame these ideas, she draws on two concepts:

     •    Memes and Memeplexes: Coined by Richard Dawkins in 1976, “memes” are self-replicating cultural units that spread and evolve like genes. Memeplexes—like religions and political ideologies—are networks of related memes.
     •    Mimetic Desire: Introduced by René Girard, this concept suggests we desire what others desire, emulating “models” in our social spheres. This can lead to rivalry and scapegoating.

Asparouhova proposes that if we take these two concepts as "canon," we can see how the internet has poured fuel on them. "Rather than ushering in an era of global peace, the internet made us leap at each other's throats," she says. 

 

What Are Anti-Memes?

Anti-memes are cultural ideas that resist spreading—often because they disrupt social harmony. Asparouhova writes, “Networks have a strong built-in immunity to anti-memes,” noting that these ideas tend to be suppressed because of their disruptive power.

Prevention—especially when it comes to sexual violence—is inherently antimemetic. Like disaster preparedness or gun violence prevention, it rarely garners sustained public or political support unless a recent tragedy has captured public attention. ATSA's Roadmap to Talking About Perpetration Prevention offers a structured approach to breaking through this “immunity” and reshaping how we talk about sexual harm.

Asparouhova herself points to how prevention is deprioritized in public discourse and policy. Consider how media attention surges and fades after mass shootings—or how funding for disaster preparedness lags until catastrophe strikes. Prevention doesn’t spread easily because it requires uncomfortable conversations and long-term thinking—both of which challenge the fast-paced, reactive nature of contemporary communications.

The same is true for conversations about treating individuals who have caused sexual harm. These conversations demand we acknowledge the harm sexual abuse has caused, to consider the harm that may occur, and requires frameworks grounded in science that address its prevalence in our communities.

ATSA's Roadmap to Talking About Perpetration Prevention

ATSA's Roadmap to Talking About Perpetration Prevention is a guide for turning anti-memetic ideas into meaningful conversations. It encourages professionals to lead with values—to explain why they work with people who have sexually harmed others or are at risk to. It provides structure for conversations that highlight our shared goal: ending sexual violence.

Although designed for ATSA members, this roadmap is for anyone ready to talk about prevention with nuance and purpose. It:
     •    Emphasizes collaboration with individuals affected by trauma
     •    Draws on decades of clinical research and evidence-based practice
     •    Makes prevention the focal point of our work—not an afterthought

Why We Need Champions

So how do anti-memes break through? Asparouhova’s answer: Champions. These are people who know how to navigate complex systems and bring difficult ideas into broader conversations. Champions help anti-memes find traction beyond their niche communities.

She writes:
“But to the right champion, even the most labyrinthine system feels like an invitation to create something extraordinary... You will know it when looking at the problem makes your heart expand with possibilities, rather than shrink away.”

If you’re reading this, you might be that champion. Because prevention faces many challenges —we need people willing to carry the message.

A Final Note

The ideas in the roadmap aren’t always easy to share. They’re disruptive. They challenge deeply held beliefs. They’re anti-memes. But they also carry the potential to transform lives and communities.
 
This year, we've been highlighting Changemakers within the ATSA community. Members who have embraced the challenge of sharing the message of sexual abuse treatment and prevention to transform their communities.  I hope you'll join them in sharing these ideas with conviction, even when they're difficult to express. ATSA has your back with evidence-based resources and professional media support when needed—that's how change begins.

What I Talk About When I Talk About ATSA

by Aniss Benelmouffok

It usually happens after the server takes our drink orders. A new acquaintance sitting across from me will politely ask where I work. 

“What do you do?” 

For friends who have previously gone down this path, this is well-tread territory. I can sense their shoulders droop, their eyes re-scanning the dessert menu. We’re going to talk about sexual abuse—and depending on the willingness of my new acquaintance it might be the only thing we talk about all night. 

"I work for an international non-profit preventing sexual abuse."

"Oh wow," they whisper, "Thank you, that is such important work. Good for you."  Do I bask in their praise and smile contentedly or do I delve deeper? 

It is important work—carried out by thousands of ATSA members whom I’ve had the privilege to work with and represent. But their gratitude is for the willingness to face trauma. They instinctively recognize it as an act done on behalf of society.

So when I accept their thanks, I make it clear it's on behalf of ATSA’s members—those who turn toward the hard truths every day in the service of preventing and treating sexual harm.

"I work for a membership organization of treatment providers, researchers, and professionals within the criminal justice system who treat and manage individuals at risk of causing sexual harm." 

At this point, the table is typically silent. My friend will have to tell us about his kayaking trip off the coast of Seattle next time. The questions and conversation will pour out. And the thing is, this conversation energizes me every time.  We discuss who is at risk of causing sexual harm, the effectiveness of treatment, that a significant proportion of sexual harm is perpetrated by youth, how sexual harm often occurs within the context of a household, and the ways fear and retribution make our policies less effective to prevent harm before it occurs. Everyone is affected by sexual harm, directly or indirectly, this is never more clear than during these conversations. These topics are foundational to ATSA members, but can be revelatory at the dinner table.

As ATSA's Director of Public Affairs, and the Editor of the ATSA blog, I am eager to bring that energy for these conversations to the blog. I hope to promote our members voices in alignment with ATSA’s mission, our strategic plan, and the evolving policy agenda. I invite all members to reach out to me to collaborate on future submissions that support this direction. If you have a post in mind, feel free to send a brief outline or summary or if you want to bounce ideas around - well that's one of my favorite things to do- lets do it!  
 
I’d like to acknowledge and thank the previous bloggers—Kieran McCartan, David Prescott, Kasia Uzieblo, and Robin J. Wilson—and the regular and guest bloggers who built this platform. I look forward to building on their foundation and continuing the conversations the blog has fostered for over a decade. 

In true ATSA fashion, we have the numbers to prove it: over 1.26 million views, more than 300,000 words, and 575 posts shared to date.

Let's add a few more views to that count. I look forward to sharing the stories of ATSA members and the vital work they do.

Spring Conference Wrap-Up and Farewell

By David S. Prescott, LICSW

As someone who has borne witness to change in clients for over 40 years, I recently found myself at a true crossroads a few weeks ago and stepped down from the ATSA Blog. This kind of change is always bittersweet. I have been very fortunate to be part of the blog since its earliest days, when Robin Wilson first established it at ATSA’s behest. The timing has been good; I am just back from many of the spring conferences in our field. Each of these conferences has been an opportunity to reflect on a long career in the field and to look forward as well.

In April, the Oregon and Washington state chapters of ATSA teamed up for a conference at the beautiful Skamania Resort on the banks of the Columbia River. The Pacific Northwest is one of the birthplaces of ATSA, and its strong independent spirit was evident at this conference. A highlight of the experience was Lyne Piché and Anton Schweighofer coming down from Canada to discuss their work with people convicted of CSAM crimes. However, the real take-away was the fact that this inaugural joint conference showed what can happen when organizations team up to talk about their work and the challenges they face. This grassroots effort not only recalled ATSA’s earliest days (often involving brown-bag lunches to discuss the use and misuse of the existing measures of the time), but also exemplified how a small group of dedicated professionals can make things happen.

The Minnesota ATSA conference convened in April. MnATSA now has a long history of highly organized events, strongly influenced by long-time members who know the audience and bring humor and camaraderie as well as numerous options for workshops. The highlights included a keynote address by Apryl Alexander, who reminded us of the importance of simply talking about the issues we face – particularly in respecting individual cultural differences. Another highlight was Jill Levenson’s keynote address on post-conviction stress and its effects on clients. Each of these keynotes would have been unimaginable 20 years ago and were only possible because of our field’s history of not shying away from difficult conversations.

A week or two later, the Oregon Adolescent Sexual Offending Treatment Network held it’s 40th anniversary conference. To celebrate, the organizers brought in Tim Kahn to provide a pre-conference workshop and then had an afternoon panel featuring Tim Kahn, Tom Leversee, and me to reflect back and look ahead. Without any question, the biggest take-away from this conference was the discussion of the use of polygraph with adolescents, especially in the wake of ATSA’s 2017 statement that it no longer supported the use of this measure. Given the role of polygraph in our field’s history, the discussion illustrated the sea change of thought and improved practice as the use of the polygraph has waned. Sadly, it was almost entirely extemporized in the moment by the speakers, highlighting a fact of great conferences: You had to be there; it wasn’t recorded or written down.

Finally, towards the end of May, the combined conference of New York State ATSA and the Alliance for the Prevention of Sexual Abuse convened. After excellent pre-conference workshops and a shared keynote by Jacque Page and Bob McGrath, Jeffrey Sandler presented preliminary outcome data from New York’s Strict and Intensive Supervision and Treatment program. One view of his findings was that this program not only has considerable impact, but that when clients do return to the system, it is more likely to be as a result of factors related to antisociality rather than problematic sexual interests. Another highlight was when New York resident Justyna Rzewinski received the conference’s President’s Award for her remarkable efforts at exposing cruel practices at New York City’s Rikers Island. Together, Sandler’s exhaustive research and Rzewinski’s courage are models for what can be accomplished in our field.

That’s it for me! I am eternally grateful to Robin Wilson for asking me to join the blog early on, and to all of those I worked with subsequently, including Jon Brandt, Alissa Ackerman, Kieran McCartan, and Kasia Uzieblo. Of course, I am most grateful to my wife, Louise, who has been patient with my fascination with this work for 32 years, and who has always been willing to speak with me as an outsider, sharing ideas and feedback. As the old saying goes, alone I can travel faster, but together we can go further.

Not the end, rather the next chapter

By Kieran McCartan & Kasia Uzieblo

Sexual abuse is a complicated and simple issue simultaneously. This is a source of concern, frustration, hope, and despair for many individuals working in the field. It is a multi-agency, multidisciplinary issue involving numerous organisations, charities, frontline services, and providers working with individuals to address the reality, causes, and impact of it. Over the years, we have come to see sexual abuse as a multi-systemic issue that impacts all levels of society (individual, interpersonal, community, societal), all facets of society (gender, race, culture, health, psychology and wellbeing), and all societies; it is truly a global issue. Part of the challenge of sexual abuse is the conversation, communication and messaging around it. Translating professional, policy and research conversations to public and community discourses to educate and upskill everyone. This was the aim of the blog when it was first established as an offshoot of the Journal of Sexual Abuse and continues to be its aim as it transitions to being the ATSA blog, aligning with its policy and practice addenda moving forward. Sexual abuse, and the blog, has always been evidence- and practice-based and politically motivated (with a small “p”), and this remains true today, but has become more critical with the current socio-political climate.

Over the years, since the first blog in July 2010 by Robin Wilson (the original lead blogger on the site), there have been 574 blogs (this is the 575th), and they have covered everything from treatment, polygraph, policing, policy approaches, trauma-informed practice, work with adults as well as children and young people, drug and psychological therapies, risk assessment, victim services and narratives, policy, practice, research, conference reviews, and obituaries for leaders in the field.  The blog has featured numerous associate bloggers and guest blog posts over the years, truly reflecting the discussions among professionals, practitioners, policymakers, and what you might expect to see at an ATSA, NOTA, ANZATSA, NL-ATSA, or IATSO conference. In doing so, the blog has succeeded in gathering a wide range of international voices and insights, albeit predominantly from the Western world, thus fostering an important global dialogue while acknowledging the need to continue expanding diverse perspectives. The blog, although aimed at professionals, talked to members of the public and highlighted critical public debates and issues. However, it is also a real challenge, as the field of sexual abuse has become more political over the last 15 years, nationally and internationally, which means that there needs to be a more strategic and coordinated approach to the blog and what it is saying.

As of next week, the blog will be run by the ATSA staff, marking an essential milestone in the evolution of the blog and ATSA’s transition from a grassroots members' organisation to a professional policy and practice organisation. The blog has been and will continue to be a central tenet of ATSA’s messaging, and it will remain so.

As we look ahead, the future of the blog lies not only in continuing to reflect the breadth and depth of professional discourse, but also in strengthening its role as a platform for engagement, advocacy, and change. Over the past 15 years, the blog has already played a vital role in informing, challenging, and connecting thousands of readers—something reflected in both its sustained readership and its consistent ranking among the top sexual abuse blogs globally. As it becomes more deeply embedded within ATSA, we believe this integration will open up new opportunities to amplify ATSA’s mission, inform policy and practice, and foster meaningful dialogue across disciplines. In times marked by increasing societal polarisation, growing misinformation, and a widespread questioning of scientific evidence and expertise, it is more important than ever that we stand strong together - grounded in evidence, united in purpose, and committed to supporting all those affected by sexual abuse.

As we pass the torch, we want to express our heartfelt gratitude to everyone who has contributed to, responded to, challenged, and supported the blog over the years. It has been a privilege to be part of this vibrant and committed community. We are proud of the conversations we’ve fostered, the bridges we’ve built, and the critical issues we’ve been able to highlight together. The field of sexual abuse prevention and response has undoubtedly evolved: there is more open discussion, policies have shifted (albeit still too few and too slow), and research continues to grow. But we are far from talking. Despite decades of effort, innovation, and intervention, prevalence rates of sexual violence remain stubbornly stable. This stark reality reminds us that the fight against sexual abuse is far from over. It calls on us to reflect critically on what works, what doesn’t, and what needs to change. We must keep pushing forward, with renewed commitment to prevention at every level: individual, relational, institutional, and societal. That’s why platforms like this blog are not only relevant but essential. We cannot - and must not - stop talking about sexual abuse, our response to it or how we individually, as well as collectively, can prevent it.

When things come up.

By Stephanie Wayda, BA.

You’ll always hear something you aren’t expecting. Through my journalistic work and recent research work, I’ve come to realize that stories of sexual abuse can surface in interviews even if the interview doesn’t directly ask about abuse.

My undergraduate degree is in Journalism from the University of Illinois at Urbana-Champaign. I wanted to go into journalism to learn how to develop the skills to help people tell their stories better. My true passion lies in storytelling. Journalism felt like a great path to learning, research and storytelling.

I’ve focused on helping others tell their story and relay important issues. In Champaign, Illinois I helped tell stories of arrests for marijuana before and after legalization showing how Black people were arrested more, a minority community surrounded by liquor and gambling establishments, and then as part of my undergraduate studies I was the Director of Photography on a documentary following women across Sierra Leone, Africa, advocating and finding solutions to period poverty for girls and young women.

Since graduating from university, I’ve been working on research related to my documentary work. Dr. Sophie King-Hill, Idrissa Kamara (Fourah Bay College, Freetown, Sierra Leone), and I are conducting qualitative research about why professionals in Sierra Leone choose careers in sexual health. We’re looking to understand the motivations of these professionals working with what is a stigmatizing issue in the context of Sierra Leone due to religion and traditional values.

Sierra Leone is a coastal West African country with a population of almost nine million people. Sierra Leone’s history includes the Transatlantic Slave Trade, Civil War, Ebola, a deadly mountain slide, and now the removal of USAID. Gender based violence in Sierra Leone is a common occurrence. According to UNFPA, sixty-two percent of women report experiencing physical or sexual violence. To combat this, the government of Sierra Leone has passed legislation such as the Gender Equality and Women’s Empowerment Act 2022. Most recently, they passed the Prohibition of Child Marriage Act 2024.

Our research, conducted in spring 2025, used narrative interviews. In the interviews, we asked participants about their backgrounds, life histories, life course development, career pathways, and current attitudes, beliefs, and context. This was to help us get a better understanding of the context of their lives and the motivations leading them to their choice to have a career in sexual health. None of the questions asked about previous experience with sexual abuse or any specific sexual health topic. Yet, in several interviews, I heard stories of sexual abuse. I wasn’t expecting to hear those stories in this research, but I did. I expected to hear stories about the context of growing up in Sierra Leone, and the challenges it presented, or stories of personal struggles, monetary or otherwise, or other positive stories about wanting to help others.

In Sierra Leone, I talked to educators who support students’ needs outside of the core curriculum, who support student health and wellbeing as well as educational achievement lesson plans, and who offer discussion or hygiene items to students in need. I talked to students at the university looking to pursue a career in sexual health. I talked to women who support other women, children of all genders, and their community. Throughout these interviews, I heard stories about different kinds of sexual abuse which were committed by different individuals. The way in which the participants opened varied from casual, short, long, or intense, depending on the person. This really spoke to the varying impact that sexual abuse has on people and that not all victims understand and process it, or recover from it, in the same way. I encountered many different stories from an array of different people and learned to navigate each one differently. From the people I talked with, I found that the abuse committed against the (survivors/victims) was by a person in the close family unit, i.e., romantic partner, mother, father, or sibling. From what people said, the family units stayed intact, and the abuse wasn't something openly discussed.

The people I’ve gotten to know in Sierra Leone are extremely compassionate and kind, but hearing of the additional adverse experiences they encountered and how that positively motivated them to help others really impacted me.

As a journalist, I’m accustomed to hearing about difficult topics and sensitive issues in interviews and having to compassionately navigate them. In the research setting, it became even more apparent that people felt comfortable opening about their experiences of abuse, again, even if abuse wasn’t asked about. I felt emotional and honored that people feel comfortable opening up to me about their experiences of sexual abuse. Before this research project and talking with professionals in the sexual abuse field, I had to develop strategies based on little previous knowledge to navigate talking with someone about their abuse. Journalism classes don’t necessarily teach you how to navigate those conversations. Much of your response relies on your compassion and understanding, which can still be effective.

Sexual abuse isn’t a topic that I feel at ease talking about or hearing about. It makes me feel deeply emotional, but I’m able to disconnect that part of myself when someone opens up. I think that everyone deserves respect and to be properly listened to and understood. After talking with someone, I can emotionally process or take measures to take care of myself, but in the moment, that person deserves and receives every bit of my attention.

Research interviews are different from journalistic interviews due to less strict guidelines and fewer oversights. Confidentiality isn’t guaranteed, and anonymity is taken very seriously if needed in journalism. Whereas research interviews value anonymity, and any recognition is taken seriously. Talking to people isn’t any different, but the adjustment to asking questions in a set way was something I easily adjusted to. I felt a lot of pressure internally to conduct these interviews to the highest standard, with minimal experience with academic-style interviewing. I anticipated less personability from myself and the participants but found that people felt comfortable and safe talking with me about their story. I found I felt far more comfortable than I anticipated. As a non-clinically trained person, I consulted with my advisor, Dr. Sophie King-Hill, to reflect on how I handled situations, and I felt like I handled them in the best way I could, not expecting the topic of abuse to come up as often as it did.

In the past few months of working with sexual abuse professionals, Dr. Sophie King-Hill, Prof. Kieran McCartan, and David Russell, I’ve learned a lot about sexual abuse and strategies to support individuals opening about abuse. Learning from these professionals made me realize how, outside of a professional environment, society isn’t equipped with proper tools or information to navigate anything surrounding sexual abuse. Their guidance and support helped prepare me for those interviews and speaking with people about their abuse.

In the U.S., I think about all of the barriers and struggles victims and their families face, such as stigma, shame, and resources. In Sierra Leone, I found that people faced the same barriers. With the interviews in Sierra Leone, I heard stories of sexual abuse, and I learned about myself in the process. I learned that I could listen to stories of sexual abuse and support individuals in the moment of opening up. I can offer agency in their opening up so they can decide what they’d like to share.

From all my experience in Sierra Leone and my reflection, I’ve truthfully found an increased sense of personal responsibility to support people in the moment of them opening up. One person I talked with wasn’t sure about opening up, and before they said anything about the issue they were going to bring up, I made sure to tell them they don’t have to share anything they don’t want to. Once they opened up, I wanted them to feel a sense of empowerment in sharing their story, so to one person I said, “You have the power now to share or not share. It’s up to you, you have all the power at this moment.”  

I’m not sure where my work will take me, but in my career, I will take my experience in talking about sexual abuse and expand my ability to talk about other difficult topics with a focus on the participant telling their story in a comfortable way. I’ve also developed strategies to listen to difficult topics. This experience deepened my cultural competence and ability to discuss difficult topics cross-culturally. Since people have been so vulnerable with me, it’s encouraged me to be more vulnerable.

The changing landscape of professional development: Online training a consideration or cautionary tale?

By Kieran McCartan, Ph.D., & Anne Eason, DCrimJ

Training frontline staff in the social and criminal justice sector is essential. It is important to have a reflective, compassionate and trauma informed workforce that can engage with sensitive and challenging topics in a way that supports vulnerable service users and allows for positive reflection as well as peer support. However, this can be challenging given the nature of multi-disciplinary work of frontline services which are often oversubscribed, under resourced and understaffed. So, how do we build a more equipped and informed workforce? Should it be through internal training or ongoing staff development or external, specialist CPD? What is the best and most effective way to engage staff and to improve their knowledge and skill base?

Traditionally, all frontline social and criminal justice staff (including but not limited to police, probation, prison, and social work staff) were trained in person. The training, whether initial foundation, degree or recruit training, was done in person in the classroom using. In more recent years, simulation and practical teaching is linked to real world examples to embed learning prior to practice placements. The role of academic and practice learning was, and still is, essential to these services, as it emphasises the importance of understanding the research and practice evidence base, as well as being able to implement it in real world, often high-pressure situations. The role of the classroom is as a safe environment for professionals to discuss, and get wrong, challenging and complex issues. A place within which they can develop reflection, compassion, and professional support structures. In person training and development adds to professional culture and enables professionals to ‘road test’ ideas and concepts before going into the field. This is particularly important with sensitive and challenging issues like child sexual abuse, neglect, sexual abuse, domestic violence, suicide, and severe mental health. The in-person training and development allows a shared understanding and an opportunity to professionally bond around these issues.

One of the notable challenges in teaching sensitive topics is that staff have different life experiences, where some may have direct or indirect lived experiences of these issues, while others will never have encountered them before and therefore, they may be quite abstract to them. Given our experiences as researchers, ex-professionals and current programme leads in the in frontline services we see this as important as staff need to understand and seek support throughout their career, including their training, and if they cannot openly discuss course content how will they be able to discuss professional practice?

The challenge that frontline services now face is that the training and staff development portfolio and delivery method are now changing from in person to online only or hybrid. This change is driven by many factors, including, the costs of running in person training; the travel time and environmental cost; the cost of repeating in person training and having a balanced, replicable training programme. The need for speedy recruitment and placement of staff (which is evident in policing and probation) as well as their geographical location are also deciding factors all of which makes online training more appealing. The online training world has developed quickly over the past 10 – 15 years, aided by Covid-19, and has opened some really positive experiences such as being able to engage with international, specialist speakers and content, having a presentation that is standardised and permanent. The online training world, and the opportunities that it offers, are limitless. However, the one challenge that it faces, and has not yet overcome, is participant engagement or issues of impact. You do not get the same discussion, reflection, or questions and answers in online training and development that you do in in person ones. Typically, trainees attend, listen but don’t often engage, which is challenging if you are discussing sensitive and challenging material. As a trainer or educator, you do not want attendees sitting alone processing challenging content and feeling unable to reach out or seek support. This is a bad starting point in any profession. It reinforces current and historical trauma and inevitably leads to practice issues and burn out. Furthermore, these topics frequently involve in-person disclosures unlikely in online forums. It is important, therefore, that we consider how online learning is used and what areas of practice can be taught safely, without impacting the learner’s wellbeing.

Online training is a great resource, but it is important to contextualise it within a wider training, mentoring, and practice portfolio for frontline staff. In addition, the content of online training needs to be considered, are all topics able to be taught online or are there certain topics (like sexual and interpersonal violence) that need to be taught in person initially and then maybe followed up with online training. It is important that sensitive issues that are at the core of service users, and some professional, lives are not taught in a removed, abstract or impersonal way. With the constitutional move to online training, it is essential that these issues are properly considered and a trauma informed approach is taken which is likely to involve at least an element of face-to-face delivery.

NOTA 2025 Annual Conference Review

By  Dulcie Faure-Walker, DForenPsy., & Kieran McCartan, Ph.D.

The annual NOTA international conference took place in Belfast, Northern Ireland, last week.  This was the first time that the NOTA annual conference had been in Belfast since 2019, our first post-covid visit. There were over 300 attendees across two days, with four keynote sessions and 38 parallel breakout sessions. For the first time the NOTA conference moved from three to two days and the organization and structure of the days took a different format.  For this blog post, we talk through the highlights of a successful, engaging, and thought-provoking conference.

 

The conference kicked off on Thursday morning with a welcome to Belfast and Northern Ireland by Lady Chief Justice Siobhan Keegan where she discussed her journey to become chief justice and the importance of understanding the causes of sexual and interpersonal abuse for all, especially judges, in the criminal justice system. The chair for the day was Miriam O’Callaghan, an RTÉ journalist and TV news presenter based in the Republic of Ireland, who discussed the importance of having an informed press when reporting on sensitive, challenging and controversial issues. Which lead directly into her chairing of the first keynote, a debate on whether the causes of paedophilia are informed by nature or nurture. Dr James Cantor opened the debate, argueing for the nature side stating that you cannot wholly explain paedophilia, not necessarily child sexual abuse in general, in social and contextual factors. Dr. Cantor highlighted research on mental health, psychology, biology and brain structure as well as function. Professor Nick Blagden, countered, emphasizing the need to recognize the importance of social and contextual factors. The two speakers came to the consensus that what is most important is to look at the individual and what the motivating factors are for them and that there is not a one size fits all explanation. Which lead Miriam O’Callaghan to emphasize that we need to do a better job at discussing these complex issues in our efforts to educate individuals, communities and society.

 

After the first keynote, the conference continued with two sets of parallel sessions, followed by lunch. The day concluded with a roundtable debate on Extremism & Online Child Sexual Abuse. This session was chaired by Iain Drennan, head of We Protect Global Alliance, who laid out the current context of online social harms, the role of social media, and the intersection between extremism, toxic masculinity and violence against women and children. The other members of the panel Professor Ethel Quayle, University of Edinburgh, Robert Richardson, National Crime Agency, & Marcella Leonard MBE, private therapist and consultant, discussed Iain’s remarks and the questions from their research, policy and practice experience. This made for an interesting debate, which highlighted the complexity of the online world and the challenges that we have in understanding the motivations of people using and viewing sexual abuse material and how it ties to extremist, not in terms of political, social and physical violence.

 

On Friday the conference was opened by Dr Stephanie O’Keeffe, the CEO of Cuan the Domestic, Sexual and Gender Based Violence (DSGBV) Agency in the Republic of Ireland, who stated that the need for a better understanding of the links between child abuse, interpersonal violence, and violence within the home was more important than ever. Which led into the first keynote by Prof. Parveen Ali who discussed her new book, with Dr Michaela Rogers, on the overlaps between sexual offending and domestic violence. The presentation reinforced the importance of understanding sexual abuse in the family context and the need for a multi-agency, multi-disciplinary approaches in responding to and preventing harm. Additionally, as with Stepanie, Parveen argued that you need an informed and educated workforce to effectively intervene. After the first keynote the conference continues with two sets of parallel sessions and lunch. The day concluded with the final keynote, which focused on place-based approaches to preventing sexual abuse in children and young people (CYP). Dr. Nadine McKillop presented research, policy and practice from Australia, emphasizing that taking a place-based approach is the most effective way for protecting CYP from sexual harm, but also in upskilling communities around the issue. She was followed by Professor Carlene Firmin who discussed the role of contextual safeguarding in preventing sexual harm across the UK.

 

Their presentations dovetailed well together and reinforced the role of the community in helping to prevent and respond to sexual harm in CYP. Notably, the final keynote reinforced the messages of the opening one, that you need to focus on the individual at risk of committing or who has committed sexual harm and work with them in their context in an individualized and multi-systemic way.

 

Across Thursday and Friday, we had 38 breakout sessions covering topics as broad as research and treatment on sibling sexual abuse, harmful sexual behavior in CYP, risk assessment, sexual abuse prevention, masculinity and online harm, treatment, desistence, and updates from HMPPS on current policy as well as practice. This year, like last year, the conference had a special online edition of the Journal of Sexual Aggression curated by Dr. Nadine McKillop; readers are invited to go to the journal website and twitter account for more information.

 

In closing, the conference was a great success, and the two-day format worked, with lots of positive feedback. It was a great opportunity to reconnect and reengage with colleagues as well as learn about innovative research, policy, and practice. The next NOTA conference will be in Newcastle, England, in mid-May 2026, we hope to see you there!

Evolutions and Challenges in Preventing Online Child Sexual Abuse: A Conference Report

By Minne De Boeck, Larissa Van Puyvelde, & Kasia Uzieblo, 

Introduction

Online sexual abuse is a global issue, and traditional approaches are increasingly inadequate in addressing its evolving forms. Various stakeholders are encountering limitations in their ability to contain the exponential rise of, among others, child sexual abuse material (CSAM) (Lee et al., 2020). Over the past years, another major challenge has emerged: artificial intelligence (AI). For this reason, the University Forensic Center (UFC), together with PROTECH and funded by the European Union, organized a conference at the University of Antwerp on January 28, 2025, focusing on new evolutions and challenges in online sexual abuse. This blog presents findings from studies on individuals who have engaged in CSAM offending, hereafter referred to as CSAM offenders for brevity and clarity in presenting group-level data.

Research on CSAM Offenders

Nina Vaaranen-Valkonen from Protect Children and Hanna Lahtinen from the University of Eastern Finland presented an overview of their various studies on online child sexual abuse. The first study aimed to gain deeper insight into the motivations of CSAM offenders. More than 72,000 individuals who searched for CSAM on the dark web participated in the study. Findings showed that 70% of these individuals were searching for CSAM for the first time, 42% had previously contacted a minor, and 55% wanted to change their behavior. Given that over half expressed a desire for behavioral change, it is essential to offer accessible and appropriate support.

They also studied the channels used to access CSAM material. The study found that 77% found CSAM on the open web, 32% via pornography websites, and 29% through social media platforms. Image sharing occurred in 32% of cases via social media. These findings debunk the idea that online CSAM is mainly or exclusively found on the dark web. Moreover, contact with minors mainly took place via social media, messaging apps, and online games (Insoll et al., 2024a). 

The 2KNOW project also investigated factors contributing to illegal sexual behavior behavior. A total of 4,549 respondents completed the survey on the dark web, of whom 68% were men. Seventy percent of participants first encountered CSAM before the age of 18. Most participants sought material featuring girls between the ages of 11 and 14, and nearly half reported having contacted a minor. The study identified several contributing factors to CSAM offending behavior in individuals active on the dark web, such as motivations (e.g., paraphilias), facilitating and situational factors (e.g., pornography exposure, internet anonymity), and certain barriers (e.g., deterrence campaigns, preventative interventions). 

Finally, the 2KNOW project also explored differences among CSAM offenders (n=3782). The research distinguished between: (1) individuals convicted of sexual offenses against minors, (2) those convicted of sexual offenses against adults, and (3) individuals with no convictions. The main findings indicate that most participants sought material featuring girls, and a significant portion had a sexual interest in children between the ages of 1 and 3 years old. 

The majority of convicted offenders sought CSAM based on a sexual interest in children. The non-convicted group showed higher levels of desensitization to adult pornography, and some reported seeking inappropriate or illegal physical contact with minors. The study further confirmed distinctions between the three groups. Convicted offenders had more extensive criminal histories, were more likely to engage in grooming and direct contact with minors, and showed stronger preferences for young children (Lahtinen et al., 2025).

Investigation and Law Enforcement

Kevin Reulens from the Federal Judicial Police (FGP) elaborated on the digital evolution of online sexual abuse from an investigative standpoint. The sexual development of minors often occurs online, which is also exploited by offenders, with the internet acting as a catalyst. This leads to the rapid spread of self-generated material and the eventual loss of control by the victim, resulting in a vast amount of CSAM becoming unintentionally available.

Technological developments also involve generative AI, which is increasingly used to create CSAM, with growing realism, more extreme content, and at greater volume. Additionally, all information on how to use this technology is being shared on abuse platforms, increasing accessibility.

Extended Reality (XR) was also discussed, highlighting the rise of platforms that integrate VR devices with audio and video to simulate touch, for example. The conclusion: these technological developments are unprecedented and evolving at an extremely rapid pace, posing complex challenges for law enforcement, prevention efforts, and evidence-based responses. 

Prevention and Treatment (Innovations) in CSAM Offenders

Ida Oeverland from the Lucy Faithfull Foundation (LFF) presented their treatment approach for CSAM offenders. LFF aims to create a safe group setting, offering information about (legal) consequences, psychosocial support, and practical guidance. The content of the programs covers various topics including offending behavior models, self-care, relationships, and relapse prevention. Sessions follow a cognitive-behavioral approach, with a focus on individual responsiveness. In 2023, 296 people participated. Participants generally reported a better understanding of their own behavior patterns and progress in managing their risk of offending. A positive impact on mental health was also noted.

Hannes Gieselier from Charité explained the STOP-CSAM project, which uses therapeutic chat interventions with adult CSAM offenders. These involve four conversations covering topics such as understanding offending behavior, acceptance of sexual preferences, personal values, emotion regulation, problem management, and a safety and change plan. Research using test and control groups showed that these interventions had a positive impact on illegal viewing of CSAM. Key takeaways included the importance of targeted, accessible, and rapid therapeutic interventions to facilitate behavioral change. However, maintaining privacy and anonymity is crucial for effective reach.

Minne De Boeck from the University Forensic Center (UFC) and Stop it Now! Flanders presented their one-on-one online support approach for CSAM offenders. The Rethink project uses an AI-based chatbot linked to a deterrence message when users search for banned terms on legal porn sites. This aims to improve referral to support services. A blended care approach has been developed, linked to the online self-help module for individuals who have viewed CSAM. Topics include expectations, problem definition and insight, safety planning, and future support needs. De Boeck also explored the potential role of AI in specific interventions related to CSAM prevention. Benefits include improved accessibility, better referral, faster and more efficient care, training support, etc. However, challenges remain, such as the sensitive nature of the topic and target group, risk assessment, and various ethical dilemmas (e.g., lack of human contact, safety evaluations).

Finally, Larissa Van Puyvelde from UFC introduced the PROTECH project, which developed an app called Salus with input from CSAM offenders themselves. The app uses machine learning (an AI application) to prevent  the illegal viewing of CSAM. It is voluntarily installed on users' devices and monitors internet traffic for CSAM or, where relevant, legal porn use. When detected, a blocking message appears and the content is blocked. Built with privacy and anonymity in mind, the app was tested in four countries at treatment centers and through Stop it Now!, with 38 CSAM offenders over a period of three to six months. In addition to using the app, participants were asked to complete surveys at fixed intervals and an interview at the end of the pilot. Most participants reported that Salus functioned as expected and did not interfere with device use. Some technical difficulties were noted (e.g., issues with other apps, slow internet, false positives). Still, the majority found Salus helpful, necessary, and supportive, and believed it could be beneficial in therapy.

Conclusion

Rapidly evolving technological developments clearly present various challenges in terms of detection and prevention. But at the same time, these developments offer new opportunities in terms of innovative prevention strategies and accessing otherwise hard-to-reach groups. Since online technology knows no boundaries, it is essential that we, as professionals, also know no boundaries in developing collaborations and  exchanging ideas to strengthen each other in the fight against online sexual abuse.

References

Insoll, T., Soloveva V., Viaz Bethencourt, E., Ovaska, A. & Vaaranen-Valkonen,N. (2024a). Tech platforms Used by Online Child Sexual Abuse Offenders. Research Report. 

Insoll, T., Soloveva, V., Díaz Bethencourt, E., Nieminen, N., Leivo, K., Ovaska, A., & Vaaranen-Valkonen, N. (2024b). What Drives Online Child Sexual Abuse Offending? Understanding Motivations, Facilitators, Situational Factors, and Barriers. 2KNOW project. https://www.suojellaanlapsia.fi/en/2know-research-report.

Lahtinen, H., Honkalampi, K., Insoll, T., Nurmi, J., Quayle, E., Ovaska, A. K., & Vaaranen-Valkonen, N. (2025). Investigating the disparities among child sexual abuse material users: Anonymous self-reports from both charged and uncharged individuals. Child Abuse & Neglect, 161, 107299. https://doi.org/10.1016/j.chiabu.2025.107299

Lee. H-E., Ermakova, T., Ververisa, V., & Fabiana, B. (2020). ‘Detecting child sexual abuse material: A comprehensive survey’, Forensic Science International: Digital Investigation [e-journal] 34, 301022. https://doi.org/10.1016/j.fsidi.2020.301022  

Change is Constant. So Is Our Work.

By Amber Schroeder

Many of us are feeling the weight of this moment. From economic instability and shifting policies to public attacks on higher education, research, and professional practice, the landscape is changing in ways that affect how we work—and how we support those we serve. For many of your clients and ourselves, this moment is changing how we live and look at our lives.

At ATSA, we’ve been hearing from members who are navigating real uncertainty: institutional pressures, loss of research funding, new legislative restrictions, growing concern about international collaboration, job loss, and fatigue from trying to keep up with it all. These challenges are not theoretical—they directly affect our ability to provide effective, accessible, evidence-based treatment, conduct high-quality research, and train the next generation of professionals in this field.

During the COVID-19 pandemic, the circumstances were isolating, but there was a strong sense of “we’re in this together.” That collective mindset helped sustain us as individuals, as an organization, and as a field. While the pressures we’re facing now are more fragmented and often harder to name—whether it’s the chilling effect of legislative scrutiny, U.S. executive orders that complicate nonprofit operations, economic uncertainty, or a travel advisory warning international colleagues against attending U.S. conferences—we need to return and lean into that same spirit of shared purpose.

Our work is about preventing sexual harm and supporting treatment for those who have caused or are at risk to cause it and holding those who cause harm accountable for their harmful behaviors. That requires space for rigorous research, clinical flexibility, and professional development that reflects real-world diversity and nuance. It’s becoming harder to do that work when DEI initiatives and trans-inclusive practices—essential components of ethical, effective care—are increasingly politicized or restricted. It’s also harder when economic uncertainty, including trade tensions and U.S. federal policy shifts, place added strain on institutions, providers, clients, and programs.

As we prepare for our 2025 Annual Research & Treatment Conference this September, we’re focused on ensuring the event supports you—wherever you are, however you’re showing up. Whether in person or online, we’re committed to making space for continued learning, connection, and collaboration. We recognize that for some, travel is no longer straightforward, and safety is a consideration that can’t be overlooked. We hear you, and we’re adapting. Please stay tuned!

As clinicians and researchers, we know that group work can create meaningful, lasting change. It’s not always easy, but when people show up and work together with honesty, structure, and shared goals, transformation is possible. The ATSA community is no different. This group—our group—has the power to shift narratives and policies, ensuring the treatment of those who cause harm remains rooted in evidence, ethics, and effectiveness. And when we come together, even in uncertain times, we move that shift forward. 

These aren’t easy times. But the work you do matters—and ATSA is here to support it.
Creating a world where ending sexual harm is a shared responsibility and an achievable goal means staying grounded in what we know works, even when everything around us is shifting. It means being clear-eyed, flexible, and committed to showing up for each other—and for the people who rely on our expertise.

These are complex times—but this community has never shied away from complexity. And we won’t start now.

Making the invisible, VISIBLE

By Joan Tabachnick, Kieran McCartan, and David Prescott

For 30 years, each of us has struggled with this essential question: How can we make the invisible visible? How can we create good research and emerging practice in the most effective way? This is especially true when our working lives sit at the intersection of research, policy, and practice, each of which often has different ways, means, and justifications to enable making the invisible visible.

In the world of sexual violence prevention, the question is how to prove that something didn’t happen because of an essential intervention, education program, or other factors that protected against harm. Disentangling evidence from practice and “proving” the effectiveness of an intervention is difficult in any field and especially so in an emerging field like sexual violence prevention. In the last 30 years we have seen incredible change – most importantly in the general acceptance of strategies to prevent the perpetration of sexual violence from members of the public to frontline professionals, to national policy makers and transnational organizations. In the wake of ATSA’s name change, with new funding for prevention, more acceptance of this perspective from the victim advocacy community, and new research emphasizing the importance of primary prevention on preventing the perpetration of sexual abuse, we were all feeling optimistic.  

Unfortunately, in the USA at this moment, we are now heading in the totally opposite direction and diametrically opposed to international trends, especially those in other anglophone, westernized countries (i.e., UK, Australia, New Zealand, and Norway, to name a few). 

Last week, this question of how we make things visible became even more important, Ironically, April is sexual violence awareness month, and yet in early April the US Center s for Disease Control’s Office of Violence Prevention was gutted, leaving research funding, national organizations, and local sexual violence prevention programs adrift (NPR, 2025).  More than two-thirds of the staff lost their jobs, jeopardizing essential programs to prevent child abuse, child sexual abuse, sexual assault, and gun violence. 

Except for one or two articles and a few organizational statements (including one from ATSA), the world has been silent.  In fact, it seems that the public has not become aware of these changes and their impact.  Much of this is due to the onslaught of political and social change and commentary going on in the USA and its reverberations around the world. Yet the impact of these cuts and layoffs will be felt by countless numbers of people for many years to come. 

Again, how do we make the invisible, visible?  How can we help people feel these changes today, this week, this month. How do we highlight the importance of prevention, its messaging and investment to communities and individuals, when the people that sexual violence prevention activities support do not often bring attention to themselves, and the topic is uncomfortable and challenging for society.

The people who benefit the most from our prevention efforts may never know anything about our efforts  because we have been successful and they have never experienced harm. More than ever, we need to shine a light on this.

What exactly are we losing?  For decades, the CDC has offered research about the risk and protective factors for those who have been sexually abused or those who have perpetrated sexual abuse.  They have also offered critical surveillance data, strategies for preventing sexual abuse, and the funding and guidance to evaluate the results.  And for decades they offered funding for research and for programs specifically through Rape Prevention and Education (RPE) funding that has been essential for the victim advocacy movement.  Again, removing this funding and these staff will not be immediately felt in the next days or weeks ahead. However, it all signals a shift in societal (or at least governmental) perspectives on the importance of sex and relationship education as well as sexual violence prevention. It will doubtless take years to re-focus communities’ attention on the scope of these issues.

While we don’t have that key strategic advice about what is the one thing that would make a huge difference.  We do know it is important to do something and look for hope in what others are doing. We need to look to our international colleagues, as well as those in related fields, for help, support, and direction.

We find hope in the courage and tenacity of our colleagues.  ATSA did not just issue a statement, they issued a call to all ATSA members in the US to contact their elected officials to emphasize the importance of research-informed policymaking in the effort to eliminate sexual violence.  If you have not done this yet, please make those calls. 

We find hope in movies and stories that take the risk to expand the narrow narrative of sexual violence, perpetrated by monsters lurking in the shadows.  Look for a new thoughtful documentary film called “Predator” that is really an expose on the salacious TV show called “To Catch a Predator”.  According to the film’s director, this offers insights into the complex experiences of those whose thoughts and desires do not match who they are on the inside.

We find hope when people begin to talk about institutional courage rather than institutional betrayal.  This challenges us to think about what we can do when we hear stories of sexual abuse and what can do within our institutions whether they are campuses or youth serving organizations or faith-based communities or government agencies.  How we can come together as communities to argue for and establish the need for sexual abuse prevention and the impact that it has across society. When leaders choose to face the harms that have happened and take the time to listen, that alone can make a difference.  And when leaders choose to ask what can be done to repair the harm, that can be incredibly healing for everyone.  The Center for Institutional Courage is collecting the research and hopefully make these stories of courage more visible. 

The CDC and the Division of Violence Prevention are essential to our work.  We cannot remain silent.  We need to find ways to talk about the importance of their work, their research, and their funding to continue our efforts on behalf of society.  Please don’t give up; look for places of hope that can help sustain us in the weeks and months and possibly years ahead. 

The role of sudden insights in making difficult changes

By David S. Prescott, LCSW, LICSW

“I know it sounds funny, but I changed that night when I got arrested. Nobody would ever believe it, but when I was in the back of the cop car… That was it. I knew I would never hurt anyone again. That’s when I really changed.”  Many professionals will hear these words and assume that this individual was engaging in impression management, putting himself into the best light he could under the circumstances.

In fact, this person (whose progress in treatment I was asked to assess) went on to describe how everyone assumed that he needed treatment in order to change (meaning to manage risks and lead a better life). His perspective was that although he had already changed, he needed treatment to help make those changes solid and durable. He also appreciated the opportunity to reflect on his life with therapists and group members.

It was an interesting way to look at the treatment process, one that our field rarely discusses. From the perspective of treatment planning, he sought to demonstrate in his actions who he had become in his identity. It was certainly a different pathway to completing treatment, although the end game was the same: the development of a lifestyle incompatible with harming others. What helped this client move forward, however, was that by viewing himself as a different person he could more easily maintain a better outlook on his future.

Another client was asked to reflect on what made him get himself together and participate meaningfully in treatment. He had made a sudden turn for the better in every respect, surprising everyone in his multidisciplinary team. He resided in one of two treatment programs located on the same campus. One night, a client into his program became highly aggressive, to the point where he overcame a staff person. The other staff member shouted out for help, telling the client to run and get help from the program next door.  While many will recognize this as reflecting several problems with program staffing, the client did what he was told.

He later recalled, “When I saw the look on the staff’s face in the doorway as I told her they needed help next door, that’s when it all made sense. I did not want to spend the rest of my life in places where all this could happen. I knew I had to do something different.” He did; he went on to make meaningful changes in his life and returned to living independently in the community. Arguably, his life changed quickly, with treatment being a means to become in his life who he now was in his heart. The clients in these cases went on to live successfully, all things considered.

How is it that these sudden insights so infrequently receive attention? We tend to structure treatment programs in a stepwise fashion to help clients change their lives slowly, and for good reason. Living one’s life differently is a lot of work. Often, our attempts to reduce risk don’t easily mesh with many clients’ progress, which can proceed in fits and starts. Nonetheless, whether we call them sudden insights, quantum changes, or epiphanies, they do happen and can be cause for celebration. They also illustrate how no one treatment plan or program is a perfect fit for every individual.

Perhaps one reason these sudden changes don’t garner more discussion is that professionals so often have a wait-and-see attitude. There was a conference presenter who observed with sarcasm that, “I’ve seen more people suddenly find God in the back seat of a police cruiser than in any chapel.” Many have seen some variation of this observations in their own practice. With that kind of attitude,  it is no surprise that professionals are very cautious. On the other hand, if we remain too skeptical, we may miss the opportunity to help clients consolidate their motivations to change and weather the storms of generalizing treatment insights into daily behaviors. As always, change can be messy and sporadic, and therapists need to work hard to make sure that they hear, understand, and respect their clients as fellow human beings.