Community, Culture, and Race: Preventing Sexual Abuse in a Culturally Sensitive Fashion.

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

There has been the discussion of cultural sensitivity and reporting, recording, and prosecution of sexual abuse, especially child sexual abuse, in the UK press this week.  Over the last 10 years, it has emerged that child sexual abuse, but particularly child sexual exploitation by networks of men in England and Wales had gone investigated because of the race and cultural heritage of the individuals in question. A number of investigations, including but not limited to the independent inquiry into child sexual abuse, found that networks of men of Asian heritage were sexual abusing girls under the age of 16 for several years. The authorities knew about the cases but did not fully investigate or prosecute. They claimed that their inaction was due to  being afraid – or at least concerned about – being seen as racist. The most recent case was about sexual abuse in Telford, and the investigation found that:

-      More than a thousand Telford children were exploited over decades.

-      Key agencies dismissed child exploitation as "child prostitution."

-      Exploitation was not investigated because of nervousness about race.

-      Teachers and youth workers were discouraged from reporting child sexual exploitation by members of minorities.

-     Offenders were therefore emboldened, and exploitation continued for years without concerted response.

-      Responses to abuse came from committed individuals not from top-down directives.

The Telford case again raises questions about the way that we think about child sexual exploitation, the language used, and the criminal justice system’s approach to it. We have moved a distance in no longer seeing victims of sexual exploitation as complacent in it. We no longer talk of them as “child prostitutes” or girlfriends or see them as willing participants as they receive “gifts” from the people who are grooming them. The police have gotten more victim focused and more in tune with the double status of young people who are victims of sexual exploitation, in that they are victims first and that offense-based behavior is often an extension of their vulnerability and history of victimization. A number of police forces across England and Wales do not prosecute young victims of sexual exploitation anymore. Rather they work to disrupt the abuse and safeguard the children; a clear example of this is Operation Topaz In Avon and Somerset and Action on ACE’s in Gloucester.

However, the same distance has not been travelled in terms of connecting with communities, especially of different ethnicities, about child sexual abuse or exploitation. The police and the criminal justice system not only need to work harder and better to hear the voices of different communities regarding victimisation; it also behoves us all to  understand that abuse is abuse, and wrong, regardless of who commits it, who the victim is, and in which community it occurred. Therefore, how can we engage better on this? Our thoughts for now are:

-   Sexual abuse is a community issue; therefore, it needs a community response. This is as much about culture, race, and location. We need to get communities together to discuss, prevent and respond to sexual abuse.

-    We need to see and recognise that sexual abuse exists everywhere and, therefore, people all communities and cultural groups can stop abuse.

-    Investigations of sexual abuse and exploitation, can occur in a culturally informed and humble way. At the same time, we can reinforce that abuse is wrong and that professionals will make the difficult decisions and follow challenging prosecutions.

-    We can engage all communities and have advisory groups that represent the different cultural and ethnic communities as well as coming together as a broader society.

-   While engaging communities, we need to have difficult conversations about race. These can include a focus on how to avoid (un)intentional racially tinged statements and how to strengthen our police forces and other relevant services to give them more confidence in entering these conversations without fear. However, we will need to engage communities meaningfully in this conversation, inviting feedback along the way, so that these communities also feel less need to consider comments or even criticisms as racist.

There is no question that police and others in the criminal justice system face many risks in their work. Professionals in our field can help provide information to help these processes.

30 Years of Innovative Perpetration Prevention.

By Jenny Coleman, Director, Stop It Now!  US

Stop It Now! (Now!) is a national child sexual abuse prevention organization currently celebrating its 30th anniversary. Now! is the only organization of its kind in the US; we serve every adult responsible for preventing child sexual abuse, including people who are worried about their own sexual thoughts and behaviors toward children. Our signature programs including a free helpline, extensive online resources, trainings for professionals and caregivers, technical assistance and policy efforts. Across our work, Now! offers hope to adults, families, survivors, bystanders and professionals with an emphasis on protective actions that hold adults accountable for protecting children and creating safe, healthy spaces. Learn more at stopitnow.org 

In 2022, Stop It Now! celebrates our 30th anniversary preventing child sexual abuse. Throughout the year and our virtual event on October 19, we’ll honor Now!’s founders, staff, volunteers, supporters and other champions in child sexual abuse prevention, and we will highlight our vision for the future of safety.

We were graciously invited to submit a blog on our anniversary activities, where we’ve been, and where we are going. But right now, it feels more important to address what’s happening in the United States in the context of child sexual abuse.

Hate groups and domestic terrorists have “hatejacked” the language of child sexual abuse – especially “groomer” and “pedophile”– to viciously attack LGBTQ+ communities and anyone else they oppose. Now! has commented on this publicity, but for our fellow members of ATSA, we have a particular responsibility to speak up when this wild misuse of language becomes public on a national and global scale.

Child sexual abuse is one of the worst things imaginable. We all want it to stop, right now and forever. We all want to keep children safe. As you know well, this “we” includes many of the people who have sexually harmed children or who have thoughts that they might.

Throwing around child sexual abuse terms as rhetorical devices only makes it harder to do the very real work of prevention and safety planning. It pushes people with concerning thoughts further into darkness. It takes a toll on victims, survivors and families. And, too often, it mobilizes groups of people around reductive, harmful slogans, policies and practices.

This comes on the heels of countless other news stories, legal cases and violent acts that led us to where we are as a country. And to that end, right now is a critical moment for child sexual abuse prevention. Though, that does always seem to be the case, doesn’t it?

In preparing for our 30th anniversary event, fellow ATSA member, early Now! staff member and expert in her own right Joan Tabachnick, PhD, shared the experience of working in child sexual abuse prevention in the early 1990s. She tells the story best, but suffice to say, no one talked about child sexual abuse above a hushed whisper, if ever. And today, Now! stands 30 years strong in having proactive, protective conversations every day about child sexual abuse, prevention, concerning thoughts and behaviors, survivor supports and safety planning.

Every day, Stop It Now! hears from caregivers, professionals and even youth who have been impacted by our prevention work. Through our Helpline, our WhatsOK youth project, our professional trainings and our partnerships, we hear the individual stories of adults stepping up and taking action to protect children.

As ever, we restore hope. It’s harder than it has been in a while, but we maintain every ounce of hope we have, and we share it freely. 

Ways Forward in the Wake of Psychedelic Therapy Abuse

By David S. Prescott, LICSW, and Natalie Villeneuve, MSW, RSW

Several weeks ago, we wrote a blog post highlighting concerns about abuse taking place within psychedelic therapy. This centered on revelations from a podcast titled, Cover Story: Power Trip, which uncovered how practitioners have engaged in abusive practices, often seemingly ignored by researchers. We have also recently written an article that explores the issues and offers some ideas on the way forward. In many cases, the evidence has been shocking. The main forces behind this podcast (and many other efforts), Lily Kay Ross and Dave Nickles, are to be commended for their efforts. As always, we have been grateful to the survivors who were willing to help us by telling their stories and reviewing drafts of our writings.

Since our first blog, other allegations have surfaced, such as this example, in which a therapist is reported to have taken millions from an elderly client who was a holocaust survivor. Although legal action against the therapist, Vicky Dulai, reportedly began in May 2021, the case was only reported in April 2022. These allegations were especially noteworthy given that Dulai is on the board of directors for the Multidisciplinary Association for Psychedelic Studies (MAPS), which initiated an investigation only after the case was reported publicly. Not surprisingly, MAPS trials are now under review over the alleged abuse of study participants.

For their part, MAPS has not appeared to prioritize the needs or rights of those who have been harmed. The above linked reporting discusses how it took several years for them to review video recordings of abuse that took place under their auspices. More recently, the distinguished trauma researcher Bessel van der Kolk has become the principal investigator for MAPS in Boston. Of course, van der Kolk himself had been fired from a position he held for many years following allegations of employee mistreatment in 2017.

It has seemed clear to us, as professionals working in the field of trauma, that the practice and research efforts in current psychedelic therapy have not fully accounted for the unacceptable risk of harm that takes place when abuse occurs. Setting aside the more overt forms of abuse already covered, it’s worth repeating that discussions of informed consent, and the withdrawal of consent have remained in short supply. Two recent examples come to mind.

The first example appeared on Twitter recently, when Ronan Levy, the founder of Field Trip (whose mission is to “bring the world to life through psychedelics and psychedelic-enhanced psychotherapy”) posted to Twitter about a man who had accidentally taken “magic mushrooms.” The original story described a police officer who had “unwittingly” taken this drug and now takes microdoses of it every day to alleviate his depression. Levy’s summary is, “From unwitting to witting. That’s the nature of wisdom.” The tweet implies that giving someone these drugs without their knowledge is acceptable. It also implies that microdosing psychedelics with no plan for termination is also acceptable. This has led us to wonder where the boundaries are in implementing psychedelic therapies are.

The second example is in some of the historical underpinnings of psychedelic therapies. A Google search on the term “There is no such thing as a bad trip” can be enlightening. Much of the history of this statement is addressed in the Cover Story: Power Trip podcast, but it is worthy of a deeper dive, such as in this post in Psychology Today, this paper in the International Journal of Drug Policy, and this article in Medium. Each is optimistic about the nature of psychedelics, but none seems to acknowledge that some bad experiences can be very bad indeed. Some survivors have described lingering effects from these drugs, as well as increased usage of them after the purportedly therapeutic experiences. While reframing adverse events in one’s life can be profoundly healing, it seems bizarre to tell people who have had bad experiences that they are looking at them incorrectly. It is completely contrary to what we know does and doesn’t work across all forms of psychotherapy. One early proponent, Salvador Roquet, was well known for initiating difficult experiences as part of his work. From the Psychology Today post linked above:

Another fascinating example is the therapeutic model of Mexican public health doctor Salvador Roquet, who had reasoned that the perennial human fear of death was the root of all forms of anxiety. Hence, Roquet purposefully subjected his patients to abuse and showed them violent and pornographic footage under the influence. This may seem crude, but some patients were allegedly better off after their trips.

Tying these threads together, there is ample reason to be concerned that the use of psychedelic therapy is not staying true to its Indigenous roots and that sub-cultures within it are emerging that tolerate and, in some instances, even encourage abusive behaviors. This is especially concerning when one considers what is at stake: the effective treatment of anxiety, depression, and trauma. It seems that psychedelic therapies as currently implemented need to examine not only the abuses taking place within them, but also the cultures that permit them. To that end, it is our hope that:

·       Practitioners and organizations such as MAPS, Field Trip, and many others will enlist the assistance of trauma experts and use survivors’ voices as their strongest guidance in moving forward. Advancing too quickly without this guidance poses an unacceptable risk of harm not only to deeply vulnerable clients, but also to these efforts more broadly.

·       These same entities can conduct extensive work into the nature of informed consent as it applies to research and practices that use these drugs. The nature of psychedelics makes them different in kind from other interventions. This work can involve considerations of how clients can withdraw consent.

·       As we indicate elsewhere, these entities can also develop active cultures of feedback from participants to ensure that the voices of those adversely affected are heard. By “active,” we mean working diligently to develop a culture in which each client’s voice is solicited, and each voice is heard, understood, and respected. This must be a collaborative culture, one in which the client is welcome to speak out with no concern about judgment or negative repercussions.

·       Finally, these entities can also guard against a practice which is too common elsewhere. All too often, psychiatric medications are assigned very quickly after brief office visits. These entities will benefit from guarding against processes that are so brief that they neglect the potential downside impact of these drugs.

It is our hope that deep considerations in these areas will be helpful to everyone involved, starting with the survivors themselves.

 

 

 

 

 

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.