Communicating about child sexual abuse with the public: learning the lessons from public awareness campaigns

By Hazel Kemshall & Heather Moulden

 

How effective are public awareness campaigns about Child Sexual Abuse (CSA) and what does research tell us about the most useful approaches?  In a recent review of such campaigns Kemshall and Moulden (2016) outline the key trends and research evidence.  The article looks at developments in techniques and methods since the 1990s.  Public awareness can be defined as a campaign that uses: ‘...media, messaging, and an organised set of communication activities to generate specific outcomes in a large number of individuals and in a specific period of time.’ (Coffman, 2002, p. 2). Campaigns can also be distinguished between those that: ’try to change in individuals the behaviours that lead to social problems or promote behaviours that lead to improved social well-being’, and campaigns that aim to mobilize ‘public will’ or galvanize public action for policy change (2002, p. 2).  Public awareness campaigns on CSA have seen both types developed, often linked to the aims and objectives of the agency undertaking the campaign.  A perennial problem in CSA public awareness campaigns has been adequately demonstrating the connection between the activities of the campaign, particularly in raising awareness, and this awareness resulting in desirable actions.  This has partly been due to methodological limits, and lack of money for evaluations. However, consideration of the available research indicates that the following are important to effectiveness:

• Developing and enhancing personal responsibility and the ability to take appropriate behaviour.  This has largely been through Bystander programmes (Banyard, 2015; Fulu, Kerr-Wilson, and Lang, 2014; Kemshall and Moulden, 2016 for a full discussion).

 

• Targeting of campaigns at specific groups and communities (sometimes through collaborative partnerships).  This has usually been via community education programmes, for example targeted at parents, carers, and perpetrators. There are mixed research results, but more recent evaluations, particularly of perpetrator targeting, have been positive (Beier et al, 2015; Kemshall and Moulden, 2016 for a further discussion).

 

• Greater use of social marketing techniques, particularly for multi-faceted large scale campaigns (Schober et al, 2012a, b;  Kemshall and Moulden, 2016 for further discussion).

Overall, the growing evidence base indicates that a focus on personal responsibility, action and skill promotion are important ingredients to success.

More recent campaigning and their subsequent evaluations have indicated that multi-faceted and multi-layered approaches can improve effectiveness.  Such methods aim to identify community based problems and solutions, with a focus on systematic evidence collection and the use of local collaborative partnerships.  A key campaign is the ‘Enough Abuse’ campaign in Massachusetts which was a ‘state-wide education and community

mobilization effort to prevent CSA in Massachusetts’ (see http://www.enoughabuse.org)

(Schober et al., 2012b; Massachusetts Citizens for Children, 2001; 2010; 2014; see Kemshall and Moulden, 2016 for full discussion).

 

Looking forward, evaluation would be improved by all campaigns having clear outcomes, intermediate and ultimate behaviour change, and short and long-term follow-up; plus adequate funding to carry out robust evaluation.  However, research to date appears to indicate that campaigns which focus on increased self-efficacy and ‘knowing what to do’; normalization of expectations to act positively; collaborative partnerships to improve effective targeting; skill enhancement; and positive framing of victims have greater impact.  Framing CSA as a social problem requiring broad, multi-faceted and multi-layered campaigns has been a significant shift, and there is both a growing evidence base on effectiveness and helpful information on how to replicate the approach (Massachusetts Citizens for Children, 2001; 2010; 2014). There has also been a subtle shift from public awareness to public action-simply being aware is not enough.   The future for CSA prevention lies not in public awareness campaigns, but rather in public action campaigns.

References

 

Banyard, V. L. (2015). Toward the next generation of bystander prevention of sexual and

relationship violence: Action coils to engage communities. New York: Springer.

 

Beier, K. M., Grundmann, D., Kuhle, L. F., Scherner, G., Konrad, A., & Amelung, T. (2015). The

German Dunkelfeld Project: A pilot study to prevent child sexual abuse and the use of

child abusive images. Journal of Sex Medicine, 12, 529–542.

 

Coffman, C. (2002). Public communication campaign evaluation: An environmental scan of

challenges, criticisms, practice and opportunities. Communication Consortium Media

Centre, Harvard Family Research Project.

 

Fulu, E., Kerr-Wilson, A., & Lang, J. (2014). What works to prevent violence against women and girls? Evidence Review of interventions to prevent violence against women and girls.

Pretoria, South Africa: Annex F. Medical Research Council, Retrieved from

http://r4d.dfid.gov.uk/pdf/outputs/VAWG/What_Works_Inception_Report_June_2014_

AnnexF_WG23_paper_prevention_interventions.pdf.

 

Kemshall, H, and Moulden, H. (2016) Communicating about child sexual abuse with the public: learning the lessons from public awareness campaigns.  Journal of Sexual Aggression, published online 6^th Sept, 2016.

 

Massachusetts Citizens for Children. (2001). A state call to action: Working to end

child abuse and neglect in Massachusetts. Retrieved from http://www.aecf.org/

upload/publicationfiles/massachusetts%20state%20call%20to%20action.pdf

 

Massachusetts Citizens for Children. (2010). Enough Abuse Campaign: Join the movement.

Retrieved from http://www.enoughabuse.org/index.php?option=com_

content&view=article&id=18&Itemid=22.

 

Massachusetts Citizens for Children. (2014). Guide Star Nonprofit Profile Charting Impact Report.

Retrieved from:

http://www.guidestar.org/report/chartingimpact/499015251/massachusetts-citizenschildren.pdf;

 

Schober, D. J., Fawcett, S. B., & Bernier, J. (2012). The Enough Abuse campaign: Building the

movement to prevent child sexual abuse in Massachusetts. Journal of child sexual

abuse, 21, 456-469.

 

Schober, D., Fawcett, B., Thigpen, S., Curtis, A. & Wright, R. (2012). An empirical case

study of a child sexual abuse prevention initiative in Georgia. Health Education Journal,

Online version January 18th 2012, DOI: 1177/001786911430546.

 

 

 

 

 

 

Restorative Justice & Sexual Harm: Restoration, Reconciliation, Retribution?

By Kieran McCartan, PhD, & David Prescott, LISCW

One of the authors was at a public engagement event recently and met a person who had been sexually assaulted by a stranger. This person said that one of the ways that she had coped with and moved forward from her experience was to write fiction related to it. She described how in her writing she had developed a rapist from 4 or 5 pieces of information that she knew about him from the case [the case never got to court as he admitted his offence]. When asked if she would be interested in meeting the man who raped her she said no. She believed that in reconstructing this man through her writing she had gotten all the answers that she needed and that meeting him would produce no tangible gain for her. This was creative response to a devastating experience led us to consider the utility, rational and effectiveness of Restorative Justice in cases of sexual harm.

The concept of restorative justice is not a new one or even a controversial one (Restorative Justice Council). Restorative Justice considers offending as a violation of both the individual and society. It follows that there are obligations for the offender, community, and the victim to achieve solutions that promote repair, reconciliation, and reassurance (Zehr, 1990). Therefore, restorative justice revolves around repairing the harm that a crime has caused (Bazemore & Walgrave, 1999). Although this definition recognizes that what constitutes crime is defined by communities that can have differing interpretations from various perspectives (i.e., victims, offenders, professionals, etc.).

Restorative Justice traditionally revolves around a meeting, or a series of meetings, between the victim and the offender for both of them to voice the impact of the offending on them and for them to reach a shared understanding of the causes, consequences, and way forward. Consequently, restorative measures are often seen as an alternative to punishment that places the offender and the victim at the centre of the system in active problem solving roles. The idea that a meeting between victims and perpetrators could be useful in both of their journeys is widely accepted for many types of crimes; however, when it comes to sexual harm the restorative justice debate becomes challenging, complex and [in part] controversial.

Currently in the field of sexual harm the closest to a mainstream version of restorative justice that we have is a controlled version of “reintegrative shaming” (as opposed to the introduction of toxic shame) (Braithwaite, 1989) through Circles of Support and Accountability (McKenzie & McCartan, 2012 in Maile & Griffiths Public engagement and social science). Historically, those who have perpetrated and been victimized by sexual harm have not had access to traditional one-on-one restorative justice, as there are concerns about its effectiveness, utility, its impact upon the victim and concerns that the perpetrator may justify or rationalize his or her actions (McAlinden, 2008). Some of the main concerns linked to restorative justice and sexual harm is the risk of re-victimization and re-traumatization and that the person who abused may become stimulated by reliving the sexual abuse through the meeting. Therefore, the unintended consequences of restorative justice often outweigh the perceived benefits. In recent years there has been a growing interest in the use of traditional restorative justice in cases of sexual harm from the restorative justice council, victims, perpetrators and professionals; but the field is still divided with many still opposing. Restorative Justice has a potentially important role to play in the area of sexual harm, because;

-          Most of those who abuse and are abused know each other and therefore may have to remain in full or partial contact with each other throughout their lives;

-          Generally, people who experience sexual harm want to know why they were victimised as opposed to another person;

-          The process can aid perpetrators in their understanding of their offending behaviour, assist in treatment/rehabilitation, desistence and potentially preventing future offending; &

-          The process can aid victims in their understanding of their victimisation and how to move on.

In the case of sexual harm, it is central to recognise that restorative justice can be daunting and controversial for those who have been victimized as well as their supporters when we think about the impact that sexual harm has. However, given the widespread nature, multitude of definitions and interpersonal relationships intertwined with sexual harm restorative justice needs to be a personal, one-on-one decision.

In the end, we come back to central questions: Do we want this person to desist from causing harm in the future? Do we want to provide meaningful assistance to those who have been harmed and those around them? Do we want to increase public safety? Assuming that the answer to these questions is yes, it follows that we should ask what we can do, especially since studies have shown repeatedly that our punishment-only responses to sexual violence do not work.

For further reading on restorative justice please see;

             Braithwaite, J.  (1989). Crime, Shame and Reintegration.  Cambridge.  Cambridge University Press.

              Braithwaite, J.  (1999). ‘Restorative justice: assessing optimistic and pessimistic Accounts.  In: M.Tonry.  (Ed). Crime and Justice, A Review of Research.  Vol 25.  Pp 1- 127.

              Marshall, T.  (1998). Restorative Justice An Overview: Restorative Justice Consortium.  London:  Social Concern.

              Umbreit, M.  (1994). Victim Meets Offender, The Impact of Restorative Justice and Mediation.  Monsey, NY. Criminal Justice Press.

Having the Talk

By Becky Palmer, MS, ATSA Prevention Committee.

Here we are, all educated folks who talk about sex, sexuality and relationships every day at work. Words like intercourse, masturbation, consent, safety, penis, and vagina are regular parts of our work vocabulary. Yes, we work with adults and juveniles who have committed sexual offenses and our children and families wonder silently or aloud, “why do you work with these people?” Did you ever think in your wildest dreams you would be talking about sex every day at work?

Now comes another matter, which began amongst some of my friends and colleagues on Facebook. Here’s how the conversation began, “Hello friends and colleagues. I have a question for you. Half-professional, half-parenting. My daughter is nearly 5 and my wife and I are wondering what to do in terms of "Abuse proofing" her. Maxims like "don't talk to strangers" are dated and misguided.”

We want to give our children the best possible information and we want to provide the most appropriate safe guards, however, even though we can easily talk about sex, having this conversation with our children really is different. It reminds me of a conversation I had with a friend many years ago as I was preparing to speak to a group of parents, providing guidance about how to “have the talk”. I asked my friend if he remembered the first time his parents talked to him about sex. Here is his recollection of the talk, “I really don’t remember a thing my Dad said, but there was a lot of sweat coming off of his forehead.” Well, we certainly don’t want our children to have a similar memory as my friend. The resulting conversation over Facebook provided many helpful tools. We all agreed it would be useful to share this information with the rest of our ATSA colleagues. The ATSA prevention committee has also weighed in with some helpful direction and tools. This blog may not be able to contain all the information but following are some highlights for parents to use when talking with your children about sex, sexuality, consent, and safety.

-       One of the most preventive steps you can take is to be an attentive and engaged parent, as you’re doing.

-       Jan Hindman's   A Very Touching Book may be useful.

-       I talk a lot about respect, both from a receiving and a giving point of view. As she gets older, I have found Harris and Emberley to be very helpful in the regular conversations.

-    For us, it includes a lot more than talking about sex or safety - it also includes things about relationships with friends and others, feeling comfortable being in control of body, thoughts, & behaviors, and knowing how to set limits with friends.

-     We emphasized we wouldn't blame or punish him if he told us about something going on or something he was worried about, even if that included him doing something "wrong". What mattered was that he would talk with us and we would try to help.

-       It was always important that both of our boys know they could talk to us when they were worried, scared, happy, concerned. Our younger son also added that there were lots of "teachable" moments along the way. As our sons got older we ordered free material from Planned Parenthood.

-     "If someone asks you to do something that makes you feel scared, worried, or uncomfortable, or if it's something you feel like you can't tell us or someone else, then it's probably something not okay." That covers a lot of ground, obviously, but it's actually helped them contextualize it, and we've had them tell us a lot as a result.

-       We made and had many opportunities to talk about respect, consent, relationships which to me were the foundation for all the sex talks that we had throughout their lives.

-      Take a look at our (www.stopitnow.org) tip sheets on Safety Planning, including our  Family Safety Plan. You may also find the following resources helpful when developing your safety plan: Prevent Child Sexual Abuse, Talking to Children and Teens, Ten Things To Remember When You Talk To Kids About Sexuality

-       What’s Happening to My Body: Book for Boys & What’s Happening to My Body: Book for Girls  by: Lynda Madaras

-    It’s Perfectly Normal and It’s So Amazing: A Book About Eggs, Sperm, Birth, Babies & Families by: Harris & Emberley

So, while some of the learned experts have provided you with books and printed and online resources, there seemed to be a common thread throughout our conversation. The sex talk is the easier conversation to have. Building and nurturing an open dialogue is the foundation for answering and teaching your children that you want them to come to you with their questions, concerns, worries and hurts. 

Bring me the Horizon! (and Kaizen)

By Kieran McCartan, Ph.D. and David S. Prescott, LICSW

Across the UK, but especially in England and Wales, the response to crime and management of those who break laws (especially those who sexually abuse) is shifting. The Conservative government has recently instituted changes to the management of offenders across the board with its transforming rehabilitation agenda. This agenda shifts the offender management landscape significantly, with one of the most contentious issues being the privatisation in the management of all low and medium risk offenders to Community Rehabilitation Companies on a payment-by-results model, with all high risk offenders remaining with a downsized, specialized probation service. Interestingly, this approach does not apply to all low and medium risk offenders. Sex offenders – regardless of their risk level – will be managed by a downsized probation service. In other words, all sex offenders are considered high risk regardless of the actual risk they pose.

In addition to these practical changes, there have been significant changes in policy and practice around sex offender treatment programmes. Up until recently, the cornerstone of sex offender treatment in the UK was linked to risk level, required that those entering treatment first admit guilt, and used cognitive-behavioural approaches. While there had always been a degree of scepticism about the impact and utility of sex offender treatment programmes, there was a view that programmes needed to be evidence based (Mann, 2014; Ministry of Justice, 2010) – or at least based on sound science – and that doing something was better than doing nothing. The Ministry of justice argued that:

·         Sex offender treatment models do not have a sufficient evidence base

·         They can therefore only be regarded as experimental

·         There are engagement issues with offenders participating

·        There are methodological limitations to the research and evaluation processes (especially  meta-analysis)

·         There is no clear consensus on the right way to treat sex offenders

                                                                                                (Mann, 2014; Ministry of Justice, 2010)

While some may argue with the Ministry of Justice’s perspective on sex offender treatment programmes in general, it was nonetheless respectable and defensible. However, this blog’s concern is that the demand for a solid evidence base seems to have started to dissolve. The swing from left to right with the conservative government, an increase in ideological (as opposed to science-based) policies, austerity and privatisation has brought about changes, but not necessarily what the Ministry advocated. What we have now is a change in the treatment of sexual offenders that might have its roots in research, but is not evaluated, evidenced based or necessarily coherent. Only time will tell; exit the “Sex Offender Treatment Programme” (SOTP) and enter “Horizon” and “Kaizen”.

Earlier this year (in March) the Ministry of Justice rapidly introduced two new sex offender treatment programmes: Kaizen (for high risk, high need, high priority offenders) and Horizon (for medium risk offenders) to replace existing SOTP programmes. Initially, it came as a surprise to many in the field, although there had long been murmurs of a change of direction, but recently it has emerged that there were issues relating to recent programmes and a related report was apparently suppressed (Daily Mail, 2017).

At first glance and on paper, the two new programmes look good enough. They appear to be strengths-based, positively orientated and focused on ideas found in the Good Lives Model and related approaches; this is certainly a welcome change from approaches of the past. The idea is that they build on and adapt the recently jettisoned SOTP – they are an update and remodelling of existing practices. As with previous versions of sex offender treatment in the UK neither Horizon or Kaizen are aimed at low risk sex offenders, but unlike previous programmes they have capacity for “Deniers”/”individuals who are maintain their innocence” which is a welcome shift. Both programmes are based on the sex offender treatment literature and pull together material from a range of sources.

-        Kaizen is based upon Risk, Need and Responsivity; multidimensional views of needs and interventions to be holistic, therefore incorporating biological, psychological and social aspects; strengths based approaches; desistance; and adaptive, appropriate and easy to engage with approaches to learning.

 

-        Horizon is based upon criminogenic needs and the recognition that sex offenders and non-sex offenders are similar and therefore addresses poor problem solving skills, poor self-regulation and relationship problems.

While these two new programmes are purportedly evidence based, it may be better to say they are evidence informed. In the pure research/evaluation/piloting sense they are not evidence based, having not been tested rigorously. This is ironic given the Ministry of Justice’s need for rigorous evidence in other areas of sex offender treatment/support (i.e., Circles of Support and Accountability). From our perspective, there are further ironies. New models often attract doubt and even scorn in the professional literature. There can be a paradox of putting down unproven innovation at the same time as there can be nothing proven until there is innovation. While we applaud the development of these new models and hope that they are successful, it is nonetheless strange to see that the Ministry of Justice’s complaints about unproven methods has led to more unproven methods being championed.

Therefore we need to make sure that the treatment, rehabilitation and (re)integration is fit for fit for purpose, publically accountable, transparent and not directed by “political”; especially in the arenas of sex offending given the increased public, media and political visibility the issue has. As Ruth Mann observed in 2014, the evil twin of evidence-based policy-making is policy-based evidence-making. It is for exactly this reason that we need more dialog and debate and not less.  

Author Q & A with Sebastian Brouillete-Alarie discussing "Three Central Dimensions of Sexual Recidivism Risk: Understanding the Latent Constructs of Static-99R and Static-2002R"

Brouillette-Alarie, S., Proulx, J., & Hanson, K. (2017). Three Central Dimensions of Sexual Recidivism Risk: Understanding the Latent Constructs of Static-99R and Static-2002R. Sexual Abuse: A Journal of Research & Treatment. Online First.

http://journals.sagepub.com/doi/full/10.1177/1079063217691965

The most commonly used risk assessment tools for predicting sexual violence focus almost exclusively on static, historical factors. Consequently, they are assumed to be unable to directly inform the selection of treatment targets, or evaluate change. However, researchers using latent variable models have identified three dimensions in static actuarial scales for sexual offenders: Sexual Criminality, General Criminality, and a third dimension centered on young age and aggression to strangers. In the current study, we examined the convergent and predictive validity of these dimensions, using psychological features of the offender (e.g., antisocial traits, hypersexuality) and recidivism outcomes. Results indicated that (a) Sexual Criminality was related to dysregulation of sexuality toward atypical objects, without intent to harm; (b) General Criminality was related to antisocial traits; and (c) Youthful Stranger Aggression was related to a clear intent to harm the victim. All three dimensions predicted sexual recidivism, although only General Criminality and Youthful Stranger Aggression predicted nonsexual recidivism. These results indicate that risk tools for sexual violence are multidimensional, and support a shift from an exclusive focus on total scores to consideration of subscales measuring psychologically meaningful constructs.

Could you talk us through where the idea for the research came from?

In French/European countries, professionals tend to be lukewarm towards structured risk assessment. As a native French speaker, I often became involved in debates about the pros and cons of actuarial assessment. By participating in these debates, I became cognizant of the conceptual limitations of this approach. Although many criticisms were warranted (e.g., limited predictive accuracy), one always “struck a nerve” with me: that risk factors are clinically meaningless statistical entities that do not enable a true comprehension of the offender.

Since the dawn of psychology, observable behaviors have been used to infer personality traits (or dynamics of the unconscious mind). In this context, why would risk factors, i.e., measures of criminogenic behaviors, be any different? Although risk factors are first and foremost statistical correlates of recidivism, they are also windows into the psychological and sociological mechanisms that lead individuals to commit crimes. This latent trait approach has been described in the works of Beech and Ward (2004) and Mann, Hanson, and Thornton (2010). Their theoretical frameworks for sexual offender risk assessment illustrated how to integrate static, stable, and acute risk factors in etiological models of risk that have far more clinical resonance than “dry” risk scales. Luckily for me, nobody had (yet) thought to empirically test these models. Thus, it became the overarching goal of my doctoral thesis.

At the start of my Ph.D., I had the luck of being put in touch with R. Karl Hanson and his research team (Kelly M. Babchishin, Maaike Helmus) by my director, Jean Proulx. It turned out that Karl had a project quite similar to mine; he wanted to explore the latent psychological constructs underlying the items in sexual offender risk scales. The goal was to shift practice from the assessment of unidimensional and “atheoretical” risk scores to the assessment of multiple risk-relevant psychological propensities. These constructs could then be combined in specific ways depending on the outcome of interest. In a way, we were exploring the building blocks of risk rather than its finite structure.

This lead to our factor analysis of the Static-99R and Static-2002R items (Brouillette-Alarie, Babchishin, Hanson, & Helmus, 2016). We quickly realized that the literature on this topic was substantive; we found 13+ studies on the factor structure of the Static-99/2002/R. Most studies obtained a solution of 3 factors (ours included): sexual criminality, general criminality, and a third factor related to age and victim characteristics. Unfortunately, none of the studies had conducted any convergent validity analyses. They interpreted the factors by looking at the items constituting each construct. Although this was a good start, we thought that more empirically grounded interpretations were necessary. This led us to the current paper.

What kinds of challenges did you face throughout the process?

Doing convergent validity analyses was, in fact, the easy part. The hard part was coming up with the factor structure in the first place (in Brouillette-Alarie et al., 2016). Jean Proulx and I started the factor analysis project in the spring of 2011, as part of my master’s thesis. Then, we involved Karl’s team, who gave us access to worldwide validation studies of the Static-99. They also (rightfully) told us that our factor analytic procedures were outdated and that we needed to redo everything from scratch (a common occurrence according to Maaike!). We dutifully did so, which led to our 2016 paper.

What do you believe to be the main things that you have learnt about the nature of the risk dimensions of the Static-99R and Static-2002R?

First, we learnt that sexual deviance is not a cohesive whole. Variables concerning sexual criminality clustered in two negatively correlated factors: Persistence/Paraphilia and Youthful Stranger Aggression. These factors were associated with different ends of the agonistic continuum (Knight, Sims-Knight, & Guay, 2013). Persistence/Paraphilia was characterized by modus operandi devoid of physical coercion and intent to harm, while Youthful Stranger Aggression was associated with sexual sadism and hostility. Furthermore, these two dimensions did not predict the same types of recidivism: the former was exclusively related to sexual recidivism, while the latter was predictive of all types of recidivism (like General Criminality). Without surprise, Persistence/Paraphilia was more common in sexual aggressors of children, and Youthful Stranger Aggression was more common in sexual aggressors of women. In sum, our results encourage researchers and evaluators to clearly differentiate between pedophilic and sadistic tendencies, as they refer to substantially different constructs. More often than not, they will not characterize the same offenders. In some rare cases (e.g., sadistic pedophiles), they will nevertheless converge into a very high level of sexual recidivism risk.

Second, we found a strong General Criminality factor that naturally converged with antisocial/psychopathic traits and domains of the Level of Service/Case Management Inventory (LS/CMI; Andrews, Bonta, & Wormith, 2004). This confirms that sexual recidivism risk comprises a general deviance dimension that is common to sexual and nonsexual offenders. The generality of criminal behavior in sexual offenders has already been highlighted by numerous authors (e.g., Lussier, LeBlanc, & Proulx, 2005).

Now that you’ve published the article, what are some implications for practitioners?

Although it is not yet ready to be implemented in forensic practice, we hope that sexual offender risk scales (and those scoring them) will adopt dimensional scores in addition to total scores. Sexual recidivism risk is unanimously considered to be multidimensional, and our current risk tools do not convincingly reflect that. It is more clinically relevant to conceptualize risk as the interaction between psychological constructs and the social environment than the sum of discrete correlates. Our research program tries to bridge the gap between those two perspectives.