The Complexities and Nuances in our Work

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

Over the last couple of weeks Kieran has been involved in several research and practice conversations about the complexity of the population that we work with. These conversations explored the need to recognize that most of the people we work with, including those who have been victimized and those who have committed sex crimes, have multiple risks and needs. Clearly, we need to recognize this diversity in formulating our responses to sex crimes. We have blogged about this before and our aim with this post is not to tread once again over old ground, but to reflect on how effective we are at recognizing and managing this complexity, especially in terms of our practices and contributions to policy making. 

Kieran’s recent conversations have focused on an independent inquiry into concerns expressed in the UK that police officers have fared poorly at recognizing and responding to child sexual exploitation. This is a challenging area because the children involved often have complex relationships with the police and the legal and child welfare systems more broadly, which further complicates outcomes (including reporting, investigations, and impact of these processes on youth). The reality is that we all need to consider our professional biases, the evidence we review, the measures that we use, and what we do with all the information we receive. To what extent do our mental shortcuts influence the health and wellbeing of others whom we influence? How can we get better at processing information and becoming more effective in our work?

The New York Times recently published a piece titled, “The Question Juror No. 50 in Ghislaine Maxwell’s Trial Should Never Have Been Asked.” This refers to jurors being asked whether or not they have been sexually victimized, with the presumption that they could not be impartial in their judgement. Once again, it seems that there are implicit beliefs about those with histories of victimization and a bias towards victims of sexual abuse without understanding the many ways that people understand, recover from, or grow wiser from their experiences. We have found ourselves questioning society’s biases regarding what a good victim should look like, including what they should do and how they should behave.

A similar thought can be made about senator Lindsey Graham’s recent statements during the hearing of Judge Ketanji Brown Jackson. Jackson stated that the number of images of online child abuse viewed or distributed shouldn’t be considered in sentencing. She considers other risk management strategies, including substantial internet supervision, as a valid option. Senator Graham clearly didn’t agree and argued that the only way to deter these offenders from committing new crimes is by sending them to jail.

The above suggests that all too often, the public defaults to dichotomous ideas, such as that people who abuse others are purely evil, that those who are victimized have had their innocence stolen and are forever damaged. The reality is that these extremes, if they exist, are the exception. Human beings are complex and nuanced. Trauma is complex and nuanced. And rehabilitation is complex and nuanced. Therefore, our task can be to question how we can best understand and discuss these issues in a non-biased, informed, reflective manner?

While we certainly acknowledge that we can have biases of our own, we come back to principles we can follow, including:

• recognizing complexity and understanding what it looks like in interviews, testimony, prosecution, policy, etc.; 
• continuing to inform the public about the complexity;
• continuing to respond to the black-and-white reasoning we hear from professionals and policymakers;
• placing compassion and understanding at the center of our practice;
• recognizing our own biases and frustrations, noting them when they emerge in our practice and being open to reflect upon them in a non-defensive way; and
• informing our future professionals, through both formal training as well as informal conversations as well as support structures, about this complexity.

Maintaining an awareness of our own biases and a fluid conversation about harm and resilience can keep us out of ruts that can only hinder our effectiveness.

 

Redoubling the call to end violence against women and girls.

By Kieran McCartan, PhD, & David Prescott, LICSW

.International Women’s Day on Tuesday the 8^th of March 2022 focused on “Gender equality today for a sustainable tomorrow”. The field of sexual abuse is often, and rightly, seen as a women’s issue as it tends to impact women more than men. However, this is a bit of a red herring as it’s really a community issue, usually committed by men against women and often underplayed, ignored, or even validated by some communities and groups. This is not to dismiss it as a women’s issue, but rather to expand the discussion and recognize it’s a social issue that we all need to respond to and work towards preventing, regardless of our gender. We all need to part of the conversation, because preventing violence against women and girls needs the engagement of men and boys.

The End Violence Against Women Coalition (EVAW) is a coalition of more than 120 specialist women’s support services, researchers, activists, victims and survivors, and NGOs working to end violence against women and girls in all its forms. As part of International Women’s Day, EVAW produced a snapshot report documenting the extent of violence against women and girls in England and Wales. The report is a useful tool in highlighting the extent and nature of abuse currently, existing best practices, and the changes needed to respond  to it. While the report covers a range of violence against women and girls  (femicide, sexual abuse, domestic violence, online sexual abuse, abuse in public spaces, and others), our focus here is on sexual abuse and rape.  The report indicates that in England and Wales:

-          In the 12-month period ending in September 2021 sexual offences recorded by the police were the highest on record, at 170,973 offences, a 12% increase from the same period in 2020.  Rape accounted for 37% of these offences (63,136 offences).

-          2.9% of reported sexual offences and 1.3% of recorded rapes resulted in a charge or summons, which has fallen from the previous 12 months.

-          41% of rape victims and survivors withdrew their support for action through the criminal justice process and declined to pursue criminal charges.

-          The London Victims’ Commissioner’s 2021 London Rape Review also found that among those who allege rape or sexual assault to police, 65% withdrew support for the case, an increase of 7% in the last two years, with nearly two-thirds of London rape victims and survivors who drop their complaint doing so within a month of going to police, and the proportion of withdrawals tripling in two years.

-          Latest Office for National Statistics data show the disproportionality of sexual assault against minoritized and marginalised women with Black and mixed-race adults more likely to experience sexual assault than white or Asian adults.

-          Cases with white victims and survivors are 1.2 times more likely than Black victims and survivors to result in a charge, and 1.8 times more likely than when victims are Asian (6.7% vs. 3.7%).

-          10 police forces did not bring a single charge over the rape of a Black victim during the five-year period, despite recording 148 reports between them.

-          Independent Office for Police Conduct (IOPC) investigation into police officers who abuse their position for a sexual purpose has shown a sharp rise in reported cases in the past three years, with this form of abuse now comprising the single largest form of police corruption they encounter.

-          After the launch of the Everyone’s Invited, 16,000+ testimonials of sexual abuse in schools were shared from girls as young as 11 years old. The testimonials named 10% of all the schools in England. Following these revelations, Ofsted launched a review that found 9 out of 10 girls had experienced sexist name calling and 92% of girls had been sent unsolicited explicit pictures or videos.

-          Girlguiding’s 2021 Girls’ Attitudes Survey found that 19% of girls aged 11-16 and 33% aged 17-21 said they had been sent unwanted sexual images online in the last year, and 9% of girls aged 13-16 said they felt pressure to share images of themselves that they’re not comfortable with.

The report highlights that there is still a lot of work needed to respond and prevent violence against women and girls. At first reading, the report is disheartening and frustrating, but it paints a realistic picture of nature of abuse in England and Wales. The report demonstrates that we must do more, and offers a number of recommendations, some of which are familiar (i.e., a multi-year, well-resourced public attitudes campaign to end violence against women and girls; a strategic investment to end abuse; far-ranging reform to the criminal justice system’s approach to this abuse; a victims’ bill that responds to the diversity of victims and survivors’ experiences with greater rights and entitlements), some of which are ongoing (i.e., ratification of the Istanbul Convention; An online safety bill that comprehensively tackles online abuse), and some of which are innovative (i.e., effective protection and support for migrant women; support for schools to implement a whole school approach). Because it enshrines a community based approach, we would like to highlight a human rights approach to violence against women and girls, as a key, essential argument in the prevention (and the cornerstone of the Istanbul Convention), as the right to live without fear of sexual abuse and violence is a vital human right for all women and girls in England Wales, as well as globally.

The prevention of violence against women and girls is everyone’s responsibility.  While the London Victims’ Commissioner’s report focused on England and Wales, the reality is that these are issues everywhere. While different countries may have different abuse rates, as well as different attitudes, behaviours, and reporting mechanism, it is safe to say that we all need to improve our responses and prevention activities. Sexual abuse exists everywhere globally, and it’s time for the global community to step up with appropriate responses to this women’s health and human rights issue. 

Bearing Witness to Suffering.

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

The events of this past week have been tragic beyond description. The Putin-led attack on Ukraine has caused further global fear and anxiety at a time when so many of us have felt wrung out from two years of the pandemic. Of course, all of these current circumstances rest on top of other concerns shared by many and discussed publicly over recent years, such as climate change, racial discrimination, and disparities, and the list goes on. Could things get any more complicated than they are? Maybe it’s better not to ask.

These events have affected many of us very deeply. As with other topics we’ve blogged about, current events extend far beyond the scope of this blog and our abilities to discuss authoritatively. These events also present a dilemma for us: Attempts to discuss them will almost certainly fall short, and yet not acknowledging them would be tantamount to turning a blind eye to suffering. Most assuredly, in one way or another, we are all bearing witness to suffering.

The fact is that many of us spend our days listening to narratives of abuse, from police reports and impact statements to disclosures of offending and of adversity in the backgrounds of clients. We then read news about people on the other side of the world in similar circumstances. There are images of people huddled underground in subway stations with backpacks and pets in the news and we catch up with loved ones deeply affected by the pandemic. Along the way we may feel guilty because others we know have it worse.

It only makes sense that with this most recent news we take the time to collectively acknowledge the stress and even the parallel processes of abuse on our caseload and in the community. So what can we do? We may be surrounded by suffering, but can we also bear witness to hope?

We certainly have no magic solutions, but we do hope to invite dialogue. What we are aware of is:

Professionals in our field care deeply about ending abuse. Our best resources include the fact that we are in this together — in the same boat and same storm. There can be relief in simply knowing this. We may disagree on some things, but we are truly united in this. We can find shelter with one another.

Many of us are professional listeners. We understand the difference between listening with a goal of understanding and other, lesser forms of listening, such as waiting for an opportunity to try to be helpful, to respond, or even to interrupt. It is easy to forget how curative being listened to can be.

In addition to listening, it important that we are considerate communicators. It is important that we communicate our ideas, understandings, and opinions in the most effective, caring, and compassionate way to the people around us. Sometimes this is about falling back on our professional training, but more often it’s about common sense and reading the room. This means that we cannot simply be on “auto-pilot” we need to be engaged and present.

Much is made of activities such as yoga, meditation, rest, exercise, and nutrition. This often comes with the price tag of feeling that maybe if we’d done more of these things, we wouldn’t feel the grief and anxiety that we do at any given moment. These are the times when we can remember that grief and anxiety come to us all and that we have an opportunity to practice many of the same skills we teach to our clients. It can also help to remember that even a few minutes of deliberate self-care can create hours of relief under the right circumstances.

Finally, it can be enormously helpful to choose self-care activities that help us be our best when we get back in the game. What talents and skills do we have in our lives that can be helpful to others? The person who enjoys cooking might help others to cook, while the person with a dedicated meditation practice might help others to meditate. Sometimes it’s as simple as giving blood simply to help someone we will never meet; generosity is also curative. It often seems that in the rush and stresses of daily life, we often forget all the things we have to offer one another. The most important piece to remember is that self-care looks different for everyone. We understand that our clients are individuals and need different responses and engagement, so we would do well to remember that we as professionals and our support systems do, too. Have understanding, not expectations.

Each reader will have additional ideas and we would love to hear them. We may have challenges, but we also have the know-how, and we have hope

Giving Back: Reflections on People Who Have Abused Supporting Those Who Have Been Harmed

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

Prince Andrew recently settled out of court in the civil case brought forward by Victoria Giuffre. The accompanying statement indicated that Andrew would provide support by "fighting against the evils of sex trafficking, and by supporting its victims." This resulted in condemnation and concern from sexual abuse charities with the implication that this was a tone deaf and inappropriate response. This raises questions about how those who abuse can offer support and give back to victims of sexual abuse or exploitation. This blog post is not a commentary on whether Prince Andrew is guilty or the legitimacy of his out-of-court settlement, but rather whether it is possible for people accused or convicted of a sexual offense to give back, assist professional practice, or support victims in their ongoing recovery?

The conversation about people accused or convicted of sexual abuse making reparations is often seen as a controversial one, with many in the public and some charities/NGO’s believing that punishment is the only appropriate route. This is a challenge, as a significant amount of sexual abuse and exploitation cases never get to court much less end in a prison sentence. This, in turn, begs the question of what comes next for accountability for their actions and how best to make reparations.

Historically, there have been conversations about the role of restorative justice (also controversial) as an alternative or additional approach to traditional criminal justice. Within the restorative justice framework, recognition, accountability, and restoration are among the most important components; the person accused or convicted of a sexual offense offers insights to their behavior and acknowledge the impact that it has had on the victim. While this is one way that people accused or convicted of a sexual offense can give back, it is a very individualized one based on the inclination of the two individuals involved and the benefits of the intervention being most directly felt by the people involved. Therefore, how do we broaden the conversation beyond the individual and the interpersonal, to make it as much about community and society?

Andrew’s suggestion was that he could support those who have been victimized from a more top-down position with a broader impact. What does that actually mean? Is that working directly with a charity, being on a board of directors, setting up a new charity, or providing a funding pot for victim services or campaigns (all of which he is well able to do given his wealth and position)? It is interesting that his ideas all seem to have his name attached to them. There has apparently been no consideration of helping anonymously or in some other quietly humble way.

Andrew’s response will be watched and commented on, but the reality is that most people accused or convicted of a sexual offense do not have the same reach or resources that he does, so how do they give back?  Some clear steps for anyone giving back and supporting people who have been harmed by sexual abuse include:

Acknowledge: Anyone accused or convicted of a sexual offense who wants to support victims, their families or the wider community has to recognize what they have done and made their piece with it. This is essential because throughout the process of giving back they may need to recognize their behavior, the issues with it, and how they can move on and support people in doing the same.

Accept: It is important to accept that the victim, their support network, related organizations, and the broader community’s, as well as society’s response to the offense that you have been accused or convicted of is out of your control. It is important to go into the process of giving back with an open mind that is not defensive and recognizes that you may be criticized, not accepted, and not forgiven.

Recognize: The most important piece of giving back is to recognize the victim and their wishes, whether they want the people accused or convicted of a sexual offense to give anything back. If the timing and the messaging is not right, then it is important to step back and not force the issue.

Manage: It is important to manage expectations around what the giving back looks like in terms of content, message, timing, and involvement. This needs to be an ongoing process that moves at the pace of the victim and their representatives.

Message: It is important to get the tone of the message and involvement right. Engagement and giving back is not about enabling the person accused or convicted of a sexual offense to feel good about themselves or to feel that they have “done their bit”. Rather is about the victim, or the victim’s organization, what they want and what they need. This can be challenging as the message maybe very different from different perspectives.

Collaborate: In giving back and supporting victims the process needs to move beyond the individuals affected, it needs to be part of a wider prevention and rehabilitation response. This means understanding the socio-political and service landscape so that messaging can be used appropriately. This means that the voice of the person who has been abused needs to be recognized, framed, and progressed accordingly.

Be open to opportunities: The changing narratives around sexual abuse, prevention, and responses, mean that new funding, research, and collaborative opportunities are opening. Some if these may look and feel familiar where others may not. They may feel uncomfortable and challenging. It is important to embrace these opportunities so that people at risk of victimization and perpetration can learn from the experience of the person accused or convicted of a sexual offense. It is important to state that in helping or working with current victims we can help and safeguard against future victimization.

The role of people accused or convicted of sexual offenses giving back and supporting those who have been victimized is not an easy one, nor a decision to be made lightly. It needs careful thought and consideration and must be done in a thoughtful, considerate, and appropriate fashion. While Prince Andrew’s offer may have failed to ignite a positive response, this may be a fault of the messaging, more to do with the tone, nature, and implied ego and intrusiveness of it.

 

What’s in (another) name?

By David S. Prescott, LICSW

In the early 2000s, I was fortunate to become friends with Jan Hindman, who had taken part in many of the original professional activities that led to the establishment of ATSA. In her inimitable style, when interviewed on her role in the history of ATSA, she referred to herself as having been “the first vagina on the board.” Jan was friendly, loving, funny, and above all never turned her focus away from the suffering of those who had been abused. She used to wonder aloud what people who have survived abuse would make of our field. She often said the words, “Victims are watching.” It was a reference to the importance of carrying out our work in a manner that is sensitive to the experiences of vulnerable people and not passing them by as we seek ever-more-accurate diagnoses and assessment tools.

Of course, given the rates of victimization in the histories of those who have abused, it’s safe to say that practitioners are not strangers to working with people who have endured extreme adversity and caused harm. However, those who split their practice between those who perpetrate and those who have been harmed often describe how challenging the work can be.  Bearing witness to suffering is hard work, and so is shifting one’s focus from perpetration in some clients to anguish in others and then back again.

Fast forward a few years and in the title of a now classic article, Gwenda Willis asked, “Why call them by what we don’t want them to be?” Her article focuses on the ethics of labeling people rather than their actions. Likewise, Willis and Letourneau (2014) wrote on the importance of accurate and respectful language. These articles played a direct role in policy shifts in multiple areas.  ATSA’s journal, Sexual Abuse, suggests that authors use person-first language. This has been the subject of other blogs and articles, and the practice of person-first language has been commonplace in the adolescent arena of practice for many years. It needs no further substantive review here, except to note that many professionals have asked whether there isn’t a new term to describe those who sexually abuse others. Unfortunately, replacing one term with another simply ends up with further reductions in accuracy, as noted above.

Inside our field and even more so outside of it, person-first language is becoming more commonplace. Interestingly, we have not seen this same focus on accuracy and respect actively applied to those who have been harmed. While many of us have tried to develop new writing skills and habits, it is still very common to hear the term “victim” used, although the APA has recently offered guidance on inclusive language.

We are not the first to notice that people who have been sexually abused frequently do not like being called “victims.” A common objection is “I don’t want to be defined by the worst thing that ever happened to me.” Many prefer the term “survivor,” while many don’t. Worse, professionals working with individuals who have committed egregious crimes are aware that not everyone who is abused actually does survive. Discussions of terminology can be highly contentious and rightfully so; we’re discussing deeply personal matters and people rarely agree on everything.

Language, of course, is constantly evolving. In the current era, it can be common to hear people using the term “victim” in pejorative ways (accusing others of “playing the victim,” or of contributing to a “culture of victimhood,” etc.). In a discussion in the development of this post, co-blogger Kasia Uzieblo observed that the Dutch word for victim is “slachtoffer.” A client described how she and others hate this word because of its linguistic origins (slacht-offer translates as slaughter-sacrifice). If there is any comfort in this, it’s that all languages seem to struggle with these issues.

Nevertheless, it seems only respectful to extend the same courtesy of using person-first language to everybody and to ask whether there is particular language that they prefer. At a time in society when respect and accuracy often go missing from discourse, this can be a good place to start.