We need to START enacting effective practices to prevent and report sexual abuse within institutions

 

By Kieran McCartan, Ph.D., David Prescott, LICSW, and Kasia Uzieblo, Ph.D.

Sexual abuse within institutions, whether big or small, is not a new phenomenon. It’s something that we have discussed on this blog before. Therefore, we are not going to re-tread old ground. In recent weeks both the Baptist Church and Hockey Canada have been hit with allegations and been levelled with criticism that they have not responded appropriately. This is agonizing for the community at large, but especially for professionals who want to help. These are the same professionals who ask for a seat at the table to inform policy, too often get rejected, and eventually see the same thing happen time and time again. In this blog post, we ask the question of why do things not change? Why does policy change, but not necessarily public attitudes, beliefs, or practice? As a society and as professionals, we need to ask ourselves, what does it take to change mindsets?

Our beliefs about the world are often ingrained in who we are, they are not hard wired but the older we get the more they are influenced and reinforced by social norms, culture, education, and personality. This does not mean that we cannot change our beliefs or behaviours, but it means that they are harder to change. If this is true of us as individuals, then it’s true if us at a community and societal level. Social and political change is hard regardless of the topic. 

The reality of social change is that it:

- needs to be personal to each individual and they must believe that they can make a difference.

- must focus on an issue that communities can come together on and feel inclusive in tackling; it needs to represent the ideas and beliefs of everyone and make people feel that a shared outcome is possible.

- needs to involve a groundswell across society allowing different communities to come together, contribute, and enact changes. Individuals need to feel that they can carry out society’s mandate for change in their own lives and communities with the understanding that everyone else is working towards the same goal.

Although the desire and drive to prevent, report, and respond to sexual abuse meets the above criteria, there are significant stumbling blocks along the way that have not been addressed, including:

- The perception of responsibility – This often looks like, “It’s an individual behavior that impacts others, but not me! It’s not up to me to police other behaviours and social change is too complicated for me to think about.”

- The reality of time – Some may be able to change attitudes and beliefs overnight, but this is not the case for everyone, especially if they do not perceive the topic as a problem. Real social change needs time and space to evolve and does not result from brief attempts to influence others. 

- The monitoring and enforcement of change – There are broader questions of who is monitoring what change, and how are they doing it? Is there discussion about what progress is happening, and how acceptable that progress is? This is particularly relevant when everyone and no-one owns the issue with the belief being someone else will monitor it. 

- The shared understanding of good practices – Making progress in any social change involves defining what good practices are and their relationship to the evidence base, especially when the evidence base is new, emerging, or non-existent. What do you implement? Who leads? Is there a single voice?

- The noise of “expertise” – Because sexual abuse is a broad area, there are many different voices. Some are positive and some negative. Who are these experts? How do you determine good from bad? How, do they align to your politics, culture, context, and location? How do we nurture an evolving consensus?

- The lived reality of sexual abuse – Given the scale and nature of sexual abuse, everyone reading this post knows several people who have experience sexual abuse (or have perpetrated sexual abuse) with an array of different outcomes. This means that we will hear stories of hope and stories of frustration and desperation. These stories can influence us for better or worse, leading to unrealistic hope or pessimism. As our friend and erstwhile co-blogger, Alissa Ackerman has observed, we are never more than a stone’s throw from a survivor of sexual abuse.

Therefore, what can we professionals do? 

- Perhaps the most important thing is to keep talking about it. We can meet, communicate, and discuss sexual abuse in shared forums.

- We can continue to identify the best practices we want to implement (as well as bad practices we want to eliminate) and expand our growing evidence base.

- We can maintain a realistic sense of what is achievable and set realistic times for their completion.

- In implementing new practices, we can appoint someone or some organisation to be in charge – to drive the bus, as it were – and make them hold us all to agreed actions and follow their judgements.

- We can agree that  we are changing social norms as well as individual actions and agree to continue to work on it in the short and the long term.

- We must continue to demand our place at the policy table and to intervene in public debates to bring and keep the nuanced, evidence- and practice-based vision in the conversation. 

50 years ago, there was almost no public discourse about sexual abuse and offending. People started talking and kept talking about the issues, resulting in a groundswell of support for change at a societal level. With that change came new challenges, involving not only our responses to offending, but the need to accept that we continue to have double standards. Ultimately, we need to help the public understand that this is about all of us.

ATSA is changing its name.

By Kieran McCartan, Ph.D., David Prescott, LICSW, & Kasia Uzieblo, Ph.D.

ATSA’s legacy and recognition are important to the overall health of our organization and its place in the world. So, too, is accurately describing our activities! ATSA has always been an ever-evolving organization within a constantly changing field. This means that it’s important every so often to stop and take stock of where we are at and what we are doing. This post focuses on the recent organizational name change from “Association for the Treatment of Sexual abusers” to the “Association for the Treatment and prevention of Sexual Abuse,” the logic behind it ,and what it means moving forward. It is the result of nearly two decades of discussion by members and various boards of directors.

ATSA was originally established to provide support and insight to professionals who worked in the field of providing treatment for people convicted of a sexual offense. It began at a time when research was scant and few resources existed. ATSA was created to champion, as well as nurture, evidence-based practice in the field and develop good practice. This is still one of the central tenets of the organization, as evidenced by submissions to the journal, the ATSA Forum newsletter, and the annual conference; but it has evolved beyond these activities with an increased focus on policy, prevention, international collaboration and diversifying research, trans-disciplinary and multi-agency teamwork. To a certain degree, ATSA has been a victim of its own success. It evolved to a position where it leads the field in North America and is a growing player internationally. ATSA is seen as one of the main go-to organizations for people working in the field, and the most important conference for academics to showcase their work. All this success begs the question of why we need to change the name. This was a question that the ATSA board struggled with, but ultimately thought that it was important so for several reasons, including:

- A lot of the work that ATSA now does is oriented towards the prevention of sexual abuse, whether that is preventing first time sexual abuse or preventing people from committing sexual abuse again. We have had a committee focusing on prevention for approximately 20 years.

- The relevance of terminology, as the field is moving away from the blanket use if terms like “sexual offender” and “sexual abuser.” Many have argued that a less stigmatising and pejorative terminology can be used. This is significant,  as the international landscape is stating to change, especially in westernized and anglophone countries, towards person- first language and away from a labelling approach. A couple of years ago NOTA, the sister branch of ATSA in the UK and Ireland, changed its name from the National Organisation for the Treatment of Abusers to National Organisation for the Treatment of Abuse for that very reason.

- A recognition that ATSA addresses abuse as a broad concept, and does not focus on just one aspect of it. Where ATSA once focused just on the assessment and treatment of individuals who abuse, we now also focus on the impact of abuse on individuals and/or the community’s reaction to it. This broader use of “abuse” in our name means that the full remit of ATSA and its partnerships are incorporated. This expanded focus is also reflected in the increasing attention paid to these three target groups at the annual conference, in scientific research and in the weekly blogs. 

- There is an additional dimension to the name change as well: there can be certain funding or partnership opportunities that would otherwise be closed to ATSA because we might be seen, incorrectly and from a distance, simply as an abuser charity/organization. While the work of ATSA is still mainly oriented in the direction of those who abuse, it is to reduce and individuals’ risk of abusing and therefore it’s about community protection, safeguarding, and victim support as well as helping people to establish lifestyles that are incompatible with harming others. Making it clear from the outset what ATSA stands for in the name is an easy way to avoid these complications.

- There is also another, significant but understated reason. ATSA frequently advocates trauma-informed, person-centered and strengths-based approaches that recognize how people who commit sexual abuse may also be the victims of other forms of abuse or trauma. Since individuals who abuse have often been victimized themselves, it’s therefore  important to recognize their dual status in our name as one would in practice.

Having received positive feedback from the membership and making the decision to move forward with the name change and put it to a vote, the members of ATSA’s board had to decide upon what the change would be. Would it be a complete overhaul or an adaption? The board felt that an adaption would be best, as many felt strongly that ATSA was a strong brand with clear messages. Therefore, the role of the name change would be to strengthen and clarify this, not to undermine it. The board decided that the word prevention should be added to the name that that abuser should be replaced with abuse. However, it was decided that the acronym should remain as ATSA and not be changed to ATPSA, as that would be too confusing and, ultimately, unnecessary. Additionally, it was felt that the twitter handle “make society safe” was also fit for purpose.

Yes, the official name of ATSA is changing but the core principles, although evolving and diversifying, are the same at heart – to provide a clear and evidenced approach for working with people impacted by sexual abuse, including those who abuse.

Celebrating the 5th anniversary of Stop it Now! Flanders: Moving into the right direction, but still a bumpy road ahead.

 By Kasia Uzieblo, Ph.D.

For several Stop It Now! projects worldwide 2022 is a festive year.  This year, Stop it Now! US is celebrating its 30^th anniversary, Stop it Now! the Netherlands its 10^th and Stop it Now! Flanders it's 5^th.

On May 19, Stop it Now! Flanders organized a symposium for practitioners to mark this milestone. As the coordinator and founder of the Flemish branch, Minne De Boeck stated in her introduction: It has been a long and winding road, but all the ups and downs have finally brought them to where they are today, a recognized organization committed to the prevention of child abuse and exploitation. To illustrate, from 2017 until 2021 1913 people contacted the helpline with on average 34 contacts per month. Of those who contacted them, 48% were worried about their own behavior and/or sexual interests, 19% were worried about someone else’s behavior and/or sexual interests and 10% were professionals. Even many more people are finding their way to the website (in 2021: 33.523), where there is a lot of information made available for the three target groups, ranging from self-help modules to tools on how to address concerns about someone's behaviour. In short, Stop it Now! Flanders has achieved a great deal in five years and clearly had reason to put its organization in the spotlight.

During the symposium, specific aspects of the functioning of Stop it Now! Flanders and Stop it Now! the Netherlands were illustrated. Wouter Wanzeele, Vincent Lambrecht, and Jeroen Heylen, all therapists and staff members of Stop it Now! Flanders explained how support via chat or telephone works in practice. They also illustrated this with a concrete case. This session not only gave us a good view of how things work behind the scenes but also illustrated how important the cooperation between Stop It Now! and, for example, specialized outpatient services is. The coordination of these services does not always appear to be as straightforward as it could be and raises important (ethical) questions for professionals: For instance, when is it important to lift the anonymity of the client? Is it justifiable that clients referred by Stop it Now! are given priority over all other people seeking help from the same specialized service? These are all important questions for which there is clearly no easy answer.

Ellen Janssen, the coordinator of Stop it Now! The Netherlands explained how they support relatives of persons who have exhibited sexually inappropriate behavior or thoughts towards minors. More specifically, they organize a series of five meetings for partners, parents, family, and other close relatives of MAPs. In these groups, they can find the necessary support and can exchange experiences with each other. Participants also obtain information (e.g., on the possible reasons why some people start watching online images of child sexual abuse or why someone commits abuse), learn how to recognize risk signals and how to set positive goals for themselves and their relatives. Janssen indicates that there is a clear need for such initiatives and that we should not forget these relatives, because they also experience suffering and are faced with countless questions, and very often have the feeling that they are alone in this.

But despite all these achievements and laudable initiatives, the symposium also made it clear that there is still much work to be done. And that became very clear from the start of the symposium. The symposium started with a poignant short film “Painfully Beautiful” by filmmaker Yvonne Nouwen, depicting a testimony of the struggles a man with his sexual interests in minors and his partner encounter every day. A must-see. But Yvonne indicated that it was not easy to start this project because her supervisors showed resistance to the theme. We, the audience, were grateful that she persevered despite these negative reactions.

Alexander F. Schmidt, from the University of Mainz (Germany), highlighted the ongoing stigmatization of sexual interests in children. This stigmatization does not only lead to self-stigmatization and psychosocial problems for the people who experience such interests but paradoxically also increases the risk of sexual offending. We, as professionals, might think yes, but this is observed in the general population, fortunately, professionals think differently. Well, Schmidt shattered this illusion when describing their recent study. They conducted an online survey in 427 Swiss outpatient therapists and the results were sobering: 21% stated that they are not willing to treat non-offending minor-attracted persons (MAPs), and only 16% stated that they were fully willing to provide treatment to these persons. As could be expected, there was even less willing to deal with offending MAPs: Only 9% indicated they would be willing to treat such a client. In addition, a substantial group of therapists had misconceptions about minor attraction and assumed, for example, that such an attraction will eventually lead to child sexual abuse. These results show that it is anything but easy for MAPs to find adequate professional help.

This was in line with our findings regarding help-seeking behaviour in MAPs, which I had the opportunity to present at the symposium. Of our 163 participants, only 40% had ever sought help. These people also indicated that they found this search for help (very) difficult. They turned out to seek help primarily via informative websites about pedophilia, from friends and family, and from the helpline Stop it Now!. Those who did not (yet) seek help were, among other things, afraid of the consequences of their disclosure; even with the anonymous helpline Stop it Now! Flanders, they had their doubts: they did not believe it was anonymous and feared that the helpline would pass on all information to the police.

 

All these problems were also acknowledged by Debby Versteege, a psychosocial therapist, who counsels clients with pedophilic interests. She is also a volunteer counselor for the website www.pedofilie.nl where she has a supporting role during for instance the group chats. She described how she deals with these clients, how she tries to increase their psychological flexibility, and - unfortunately - what resistance she encounters from her colleagues, colleagues who regularly express quite wrong and stigmatizing ideas about pedophilia and are not willing to work with MAPs. Versteege had invited for her session, Gabriël Levy. Gabriël describes himself as a non-offending MAP and has been working as a volunteer with the aforementioned website for years. It was striking that all questions from the audience after this session were addressed to him. This clearly shows that professionals, even when working with MAPs, have many questions of their own and that it is so important that we not only talk about MAPs but first and foremost with them if we are to fully understand and adequately address their experience and their concerns. 

Our fellow blogger and colleague, David S. Prescott, the online session addressed many questions that professionals may have when working with offending and non-offending MAPs. He emphasized how important it is to pursue three goals in treatment: enhancing well-being, enabling self-acceptance and self-compassion, and reducing risks. He eloquently described how he worked and what he focused on in psychotherapy. He emphasized how, among other things, empathy and a non-judgmental attitude are of immense importance if a therapeutic relationship is to develop and if counselling is to lead to positive results. He also did not shy away from taboo subjects such as (chemical) castration and lie detection. What was clearly appreciated by the audience was not only the content of his lecture but also the fact that he spoke mainly from his own clinical experience and shared his own insights with the audience. The online Q&A afterward clearly showed that the audience appreciated the content of his lecture, and also the fact that he spoke mainly from his own clinical experience and shared his own insights with the audience. This shows how important it is to create a platform where professionals can share not only best practices but also their own positive as well as less positive experiences.

The symposium made clear what Stop it Now! Flanders achieved this in a relatively short time thanks to the efforts of all those actively involved and the partner services of the helpline. Yet, it also made it painfully clear that a lot still needs to be done and that we should initially dare to take a critical look at our own attitudes and knowledge about MAPs and of those of our fellow professionals. The organizers were rightly pleased with the turnout of more than 100 people. But the question it raises for me is: How can we effectively reach all those other professionals who clearly have misconceptions and exhibit negative attitudes? How can we avoid that we only preach to the choir? It is obvious there is a need to include this topic in the relevant training programs at for instance colleges and universities. But will that be enough? Stop it Now! Flanders clearly takes its responsibility in this regard and beyond. But it needs all of us to achieve its important objectives. So, let’s put our shoulders together under Stop it Now! Flanders (and similar projects worldwide) to make sure that they can further optimize and expand their important initiatives, and that they can blow out 10 candles in 2027.

 

The Return of the annual NOTA conference: Leeds 2022.

 By Kieran McCartan

Two weeks ago something out of the ordinary, well for recent years, and very familiar happened in Leeds at the Queens Hotel: the annual NOTA [in person] Conference!! The conference took place from the 4th– 6th of May with 230+ people in attendance. This blog will give you an overview, and a flavor of the conference.

NOTA debated long and hard about whether to have an in-person conference, we thought about doing the conference online again or moving to a hybrid model. In the end, we decided on doing it in person as it felt that this was the direction of travel for a lot of conferences and training coming out of the pandemic and, after talking with members and presenters, something that attendees would value and benefit from, given the increased opportunity for networking and conversation. The conference was originally going to be at the Queens Hotel Leeds in the autumn of 2020 but got moved online, and after some successful negotiating by the NOTA general manager, we were able to move it forward to 2022. Some of the eagle-eyed among you will notice that the conference has moved from September to May, this is something that the NOTA board has been discussing for a while (thanks NOTA Scotland for agreeing to move your annual conference too late August) and so, post-pandemic, it seemed like a good opportunity to try it out. Which, I feel as both conference chair, presenter, and attendee, has worked out well.

Planning an in-person conference in the shadow of COVID, which is still present in the UK, was a challenge as we did not know who would attend and if people, including presenters and attendees, would have to cancel at the last minute; some did but not many!! The choices of keynotes, we decided, would be focused on people from the UK and Ireland to limit the potential complications and fallouts from international travel.

The conference kicked off with Sarah Brown, Chair of NOTA, welcoming everyone back and stating that it was great to be back in person at a live conference. The first keynote was Simon Hackett who kicked us off with a recognition of COVID and its impact, from a personal and professional perspective, before going on to discuss how the field of working with Harmful Sexual Behaviour in youths has changed over the years and if we need to redevelop concepts and practice. This was followed by Jessica Woodhams talking about the impact of working with other people’s trauma, especially for case investigators, and how we need to train and support staff better with compassionate leadership. This was followed by two sets of workshop sessions, each with 8 parallel streams, that included everything from emerging research on paraphilias, to harmful sexual behaviour, to the treatment of those convicted of a sexual offense, and the reality of online harm's as well as ways to safeguard against them. During the reception on Wednesday, we had a first for NOTA, a posters presentation session, and we had 10 Ph.D. and postgrad posters on display; it was a great success, a particular thanks to Dulcie for all her help with this, and will be something that we are looking to replicate again next year.

The Thursday keynotes started with Stuart Allardyce and Peter Yates discussing the emerging field of Sibling Sexual Abuse, or Behaviour as they referred to it, which dovetailed nicely with Simon’s keynote the day before. In discussing Sibling Sexual Abuse, they stated that, although it was not a new concept, professionals had to better equip themselves to understand and respond to it more effectively, especially to help identify as well as respond to it. This was followed by Russell Knight and Claire Barker, from the Independent Inquiry into Child Sexual Abuse talking about the progress of the Inquiry with a special focus on the truth project and how they listened to as well as integrated the victim’s voice into the process in a trauma-informed way. Interestingly, trauma-informed practice became a central theme of the conference, although it was not intended to be, which shows the salience of the issue. After the AGM we had two sets of workshop sessions, each with 8 parallel streams, which covered several topics including Sibling Sexual Abuse, partners of men arrested for IIOC, as well as presentations by Stop it now, Lucy Faithful, and Barnardo’s.  Thursday night was the conference networking event, which was for many the highlight of the three days as it gives us the opportunity to catch up and meet new colleagues.

The final day of the conference started with Tamara Turner-Moore and Mitch Waterman discussing ideas around sexual deviance and the DSM-V, which was interesting as they challenged many of the main foundations of the DSM assumptions through their data. They argued that many of the DSM definitions, and understandings, are premised on myths that are not appropriate or that do not hold up to the continually developing evidence base. The final keynote of the conference was a roundtable led by me on the new Council of Europe recommendations on the assessment, treatment, and management of people accused or convicted of a sexual offence. I provided an overview, and context, of the recommendations before Mark Farmer, Jon Brown, and Sarah Brown reflected on the impact of these on policy, practice, and research respectively; with the feeling being that these recommendations were a positive thing and that the UK was already quite compliant with them with the prospect of interesting adaptations being opened up.

The NOTA 22 conference was a great success, with attendees leaving feeling refreshed and upskilled. The highlight of the conference for me, as well as many others, was the opportunity to be in a room with each other discussing research and practice in the field of sexual abuse. The opportunity to talk and network, was significant as the research and practice knowledge grained. The NOTA 2022 conference, which was the 30th Anniversary conference, would not have been possible without the organization and support provided by the conference team, especially Malcolm and Andi as well as their colleagues behind the scenes. 

We hope to see you at NOTA 2023 which will be from the 3rd – 5th of May in Cardiff with the call for papers going out over the summer!!

ATSA’s New Webinar Series on Campus Sexual Misconduct.

 By Joan Tabachnick and Jennifer Cinicolo

During the past decade, effective victim advocacy, changes in public policy, and a growing spotlight on horrific cases have focused the public’s attention on campus sexual misconduct.  Research confirms the need for increased attention in this area, as college-aged women experience the highest rates of sexual violence of any group. According to a 2020 study by the American Association of Universities, 26% of female and 7% of male undergraduate students experience nonconsensual sexual contact during their four years on campus.[1]

ATSA is defining it’s voice in the response to campus sexual misconduct, first drafting a public policy statement, which outlines what is known about the perpetration of sexual misconduct and identifies the potential for ATSA’s critical contributions to the campus world[2].  ATSA then submitted comments regarding the proposed US Department of Education Title IX regulatory changes[3].  The most recent changes opened to door for ATSA members by requiring equitable services for the students who have been harmed and the students who have been accused or found responsible for sexual misconduct. Even with this opening, there continue to be concerns and questions about how this current policy handles those who engage in sexual misconduct.

Campuses have begun to seek out expert guidance about effective interventions for the students who have been accused or found responsible for sexual misconduct. This is where ATSA members have a unique voice and expertise to offer.  By offering access to the research and practice knowledge about individuals who have sexually harmed, colleges and universities will be able to make more informed decisions about those students who are in the system.  With this information, campuses will also be able to move one step closer to achieving the important goal of preventing sexual misconduct.

We also recognize that the campus world is very different from the current criminal justice environment that most ATSA members work within.  Through surveys conducted by ATSA’s prevention committee, we learned that many ATSA members have interest in this work, but need more information, background about changing regulations, and insights into working with a broader range of behaviors as well as non-adjudicated students. 

To address these identified areas, a working group of the Prevention and Public Policy Committees created a new listserv to share resources, research, and case consultation advice for ATSA members beginning to work within the campus setting. 

Beginning in June 2022, ATSA will be hosting four free webinars, bringing in both outside experts as well as ATSA members with this unique expertise to cover two key areas:

I.         What do ATSA members need to know about the campus world?

II.       How can ATSA members apply and modify their unique knowledge and expertise to the diverse needs of the campus world? 

We are pleased to announce our first webinar on June 1, 2022 at 3pm EST (12p PST). This webinar features Rachel King, PhD, an expert in restorative justice practices and former Title IX coordinator at Curry College.  Rachel will provide an overview of the campus environment, Title IX process, and restorative justice.

1.       Campus 101: Overview of the Campus Process and Everything you needed to know about how the campus world will respond with Rachel King, PhD of RKResolutions (June 1, 2022)

 To register for this June 1 Session at 3pm EST click here.  

The following sessions will focus on:

2.       What is Changing and What is Possible with Jay Wilgus JD (on June 20, 2022, 3pm EST)

3.       Risk/Needs Assessment with Campus Populations:  Differences, Similarities and Practical Applications with Katie Gotch, MA, LPC (September 2022)

4.       Applying ATSA Member's Knowledge:  Case Conceptualization on College Campuses with a clinical ATSA panel moderated by Jennifer Cinicolo, LMHC (September 2022)

Look for more information about each of these webinars in the coming months.   Please consider joining this listserv and one or more of these webinars.  We hope you will join us! 

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[1] AAU Report:  https://www.aau.edu/sites/default/files/AAU-Files/Key-Issues/Campus-Safety/Revised%20Aggregate%20report%20%20and%20appendices%201-7_(01-16-2020_FINAL).pdf

 

[2] ATSA Campus Public Policy Statement:  https://www.atsa.com/pdfs/Policy/Addressing%20Campus%20Sexual%20Misconduct%20FINAL.pdf

 

[3] ATSA Comments on Title IX Proposed Changes:  https://www.atsa.com/Public/Office/Legislation/ATSATitleIXRuleChangeComment2021.pdf