Friday, August 29, 2014

Minority status & the perpetration of child sexual abuse

Child sexual abuse is a difficult issue to discuss at the best of times. The conversation around child sexual abuse is more challenging when we move from a stereotypical offender-victim paradigm (i.e., white male perpetrators and young white female victims) to non-traditional offender-victim paradigm (e.g., learning disabled offenders, minority offenders and/or female offenders).  The main issue is that the conversation surrounding the non-traditional offender-victim paradigm can become conflated with issues of political correctness, potential racism, potential sexism and discrimination. I am not saying that these concerns are not real or important, but rather they should not be used as a roadblock for avoiding difficult sexual abuse questions, as has seemed to be the case in the recent child sexual abuse scandal in Rochdale, England. Child sexual abuse is a wide and varied field and, as such, it is important to recognize that anyone can be a sexual abuser and/or a victim.

On Tuesday 26th August 2014 Professor Jay released her independent enquiry into the sexual abuse of children by members of the Asian community in Rotherham, England, between 1997 and 2013. The independent enquiry was called for by Rotherham city council (BBC) and suggests that (at a conservative estimate) 1,400 child victims were violently and systematically abused over a period of at least 15 years by organised “gangs” of Asian male perpetrators in the Rochdale area. In the report Professor Jay highlights a number of systematic failings made within and across a range of public services (i.e., social services, child services, the police and local government) which enabled the abuse to continue. The main failing appears to be an inability to respond appropriately to the role of minority groups in the perpetration of child sexual abuse. Professor Jay highlighted in the report  (as well as in her press release) that “Several staff described their nervousness about identifying the ethnic origins of perpetrators for fear of being thought racist; others remembered clear direction from their managers not to do so” (Jay, 2014; 2).In the subsequent media coverage that has emerged over the last couple of days, since the publication of the report, it has become evident that the race and minority status of the perpetrators played an important role in Rotherham city council’s reaction to the reports and prosecution of the sexual abuse (i.e., that victims were not listened to, stories where downplayed and opportunities to investigate/follow up where missed) (BBC News, Telegraph). The Rotherham case is not the only large scale case to come to light in the UK over the last couple of years involving the preparation of child sexual abuse within and by minority communities, with recent cases in Oxford, Derby, Rochdale & Peterbough (BBC). This is not to say that minority communities are more, or less, likely to commit child sexual abuse anymore than non-minority communities; rather we are starting to learn more about abuse that exists within these communities.

Minority communities can often be classed as “hard to reach” communities in respect to sexual issues (including sexual health and sexual abuse) because of perceived beliefs, culture, social structure, and approaches in discussing sexual matters (Cowburn, Gill & Harrison, 2014; ESRC online debate 2 - Access to and the impact of sex offender disclosure on minority groups). This means that traditional/mainstream approaches to policing, public engagement and education around sexual abuse may not work as well with these communities. Hence, we need to talk with different “publics” about sexual abuse in different ways (McCartan, 2013).  In this case, talking to a minority community will not be the same as talking to a mainstream “white” community, the same way that talking to a working class community might not be the same as talking to a middle class one  (ESRC Online discussion 1: Public understandings of sexual abuse and sexual abusers; Leverhulme Online discussion 1: Sexual abuse as a Public Health Issue). This means that prevention, ideally, shoule be multifaceted and tailored to the communities at hand.   A one-size-fits-all model can present both ethical and logistical dilemmas.

When the mainstream engages with minority communities in conversations about sexual violence and prevention this needs a two-track approach:   respecting their cultural beliefs and own ways of engaging on the topic, while simultaneously conveying the broader social and cultural approach in a way that they can engage with. One of the best ways of doing this is through the use of community “stakeholders”; people from the community who are invested in the community (Kemshall, 2012; NIACRO Base 2), and therefore accepted by them, and willing to work with the mainstream in developing a coherent, achievable approach to sexual abuse.

The development of a systematic, far reaching, and in-depth approach to sexual violence is challenging, and, to do it properly, means that we have to be willing to have the uncomfortable conversations as well as the easy ones. As a society we need to recognise that sexual abuse can be perpetrated by anyone regardless of education, economic means, or community status ., We should not  avoid confronting uncomfortable sexual abuse claims because it may be challenging or politically difficult. We should pursue every claim of sexual abuse with the same rigour, customize prevention efforts to respect cultures and demographics, and only then will all of society truly understand the reality and pervasiveness of sexual abuse.

Kieran McCartan, PhD

Cowburn, M., Gill, A. K., & Harrison, K. (2014). Speaking about sexual abuse in British South Asian communities: offenders, victims and the challenges of shame and reintegration. Journal of Sexual Aggression. iFirst –

Kemshall, (2012) Public sector and voluntary responses: dealing with sex offenders. In: J. Brown and S. Walklate (eds.) Handbook on Sexual Violence. London: Routledge

McCartan, K. (2013) From a lack of engagement and mistrust to partnership? Public attitudes to the disclosure of sex offender information. International Journal of Police Science and Management, 13 (3), pp. 219-236.

Friday, August 22, 2014

The anonymity debate

This was not the blog I sat down to write, that’ll come in a couple of weeks. 
This blog was instead prompted by recent events and news on the evening of Monday 18th August 2014 in the UK. Last week Sir Cliff Richard’s house was searched by the police in regard to sexually inappropriate offences that took place in the 1970’s, while that may have been challenging for some to accept that was not the main furore; the police tipped of the BBC, who recorded the whole “raid” live, and did not inform Cliff (Daily Mail). Both sides are blaming the other and claiming that they themselves were not in the wrong (the independent). Reaction has condemned the Police and the BBC (Yorkshire postTelegraph), and society (the independent); however, people came forward with allegations against Cliff [London evening Standard]. The whole event has left an uneasy feeling.
The ITV News (one of the main news broadcasters'in the UK) on 18th August 2014, commissioned a poll to look at public attitudes to anonymity for sexual abuse defendants prior to being deemed guilty by a court [ITV News],  which is a hotly debated issue raised a number of times in the press (Huffington Post;The Scotsman) and in parliament (House of Commons - Home Affairs - Fifth Reportthe independent), as well as by defendants (ITV news). Part of the explanation for the argument for anonymity is because sexual abuse allegations are so stigmatic and tend to linger in the public mind set regardless of whether the defendant is found not guilty or not (i.e., “no smoke without fire”). The ITV poll found that 74% believed that people facing sexual abuse allegations should receive anonymity prior to a guilty verdict.
This debate is not a straightforward one, it is exceptionally complex one with a number of  interested as well as invested players; the aim of this blog is not to answer the question but to prompt debate and reflection. Some of the main arguments, as I can see them, are from;
Victim – Identifying there defendant gives credence to the victim in the sense that it recognises and validates their abuse claims; it shows them that the criminal justice system is taking them seriously and in doing so it helps them in their journey for justice. It progresses the fight for victims rights. However, outing the defendant can sometimes out the victim, especially if they are vulnerable (i.e., victims of child sexual abuse have anonymity in the UK and there have been cases where poor reporting has resulted in the victim’s identity being outed) and make them feel vulnerable, under pressure pre-trial.
Defendant –The identification of the defendant means that those others around them are aware of their offences, potentially stopping them going underground, making sure that they stick to their pre-trial arrangements, preventing them from reoffending and/or making sure that they do not approach the victim. In addition, other defendants get named in other offences, why should sexual abuse be any different? But sexual abuse has a massive social stigma attached that negatively impacts the defendant, regardless of guilt or the court’s decision, which can impact their current and future lives (i.e., jobs, family life, etc) (ITV news), affecting their mental health and (potentially) increasing their potential risk as well as dangerousness to themselves and/or others. Interestingly, we spend so much academic and professional time discussing community notification post release, forgetting that we notify the community and disclosure their information pre-trial.
Criminal Justice System - This one is most complex position as there is a requirement to protect the public balanced against upholding victims’ rights, defendant’s rights and the integrity of the case (i.e., not to negatively impact the outcome of the case in court or in getting to court through inappropriate procedural behaviour). In short, maintaining the “innocent until proven guilty” aspect of the criminal justice system regardless of related social, personal or professional attitudes. Sexual abuse cases generally fall within a punishment paradigm which means that the core tenants of the criminal justice system can be diametrically opposed, rather than work in tandem.
As I said at the beginning this is a complex issue with no straight forward answer, there are a lot of involved, interested and concerned parties. I for one am not suggesting any distinct course of action, but instead saying that the identification of sexual assault defendants pre-trial outcome has consequences on them, their families, their victims and the criminal justice system: if we are reframing the sexual abuse debate we should look at all angles of it, including this one, regardless of how it makes us feel.
 Kieran McCartan, PhD

Friday, August 15, 2014

Correcting Course: Have We Missed the Boat on our Clients’ Adverse Experiences?

A recent discussion on the ATSA listserv was worth following. It began with the simple question of what sorts of trauma-informed systems of care exist for adolescents who have sexually abused, and extended well beyond. One member basically asked why it is only now that the notion of trauma-informed care seems to be coming into vogue in our field. It is an excellent question with no clear answers for now. One member commented on how in the past many therapists noted that their clients seemed to excuse their abusive actions by claiming that they had themselves been abused. Clearly, a side effect of helping clients in the direction of becoming accountable for their behavior could be the therapist’s implicit or explicit minimizing of their past experiences. This ATSA member commented that while it can be necessary to help people move through defensive excuse-making into a more honest conversation, the original intent of holding clients accountable was never to dismiss the harm that had been done to them.

A case from the author’s experience is haunting and illustrative. In one agency that employs polygraph examinations, it was routine to polygraph clients on their disclosures of past victimization, apparently with the underlying assumption that their clients often sought to excuse their behaviors. While this use of polygraph could itself be the subject of many other discussions, an interesting situation arose when the therapist ordered a polygraph to verify the account of a client in treatment who claimed a lengthy history of sexual abuse as a child. He had received individual therapy for this over the course of a year. Upon failing the examination, the client said that in fact he had been lying to his therapist about this abuse all along. He went so far as to use uncouth language to assert that his treatment team were na├»ve and foolish for believing him.

Whatever the truth in the above client’s case (and setting aside other florid concerns about his functioning), one is still left with the question of whether other adverse, even traumatic, experiences in this client’s life contributed to his offenses and his behavior in treatment. What events in his background led him to believe that it was in his interest to interact with others this way? In other words, when we ask about abuse, are we asking the wrong questions? Often the question seems to be dichotomous: was he abused or not? Perhaps it’s better to explore all the formative events of one’s life. What are the many ways in which our clients might have been hurt? What sense did they make of these events? How have these events contributed to their views/schemas of themselves and others?

Very little research has shown a direct link between one’s victimization and propensity to abuse. Although controversial, authors as diverse as Susan Clancy and Bruce Rind have observed that not everyone who has been abused experienced their situation as abusive, and many believe that it had little or no effect on them. Certainly, the vast majority of people who are victimized do not go on to abuse others. Yet in our rush to treat only those factors that proximally contribute to re-offense risk (in adherence to the need principle) we could be overlooking important ways to make our treatment more meaningful to our clients (in adherence with the responsivity principle). Ultimately, the question is how effectively can individual clients build safer futures when they don’t have an adequate opportunity to transcend their own past?

A couple of recent studies are worth mentioning. Reavis, Looman, Franco, & Rojas (2013) administered the Adverse Childhood Experience (ACE) Questionnaire to 151 people who had been violent towards children, engaged in domestic violence, sexually abused, and had stalked others. They found that these types of offenders had significantly higher rates of adverse childhood experiences than men in the general population. Only 9.3% of the sample reported no adverse events in childhood, compared to 38% of the male sample in the ACE study, and 48% reported four or more adverse experiences, compared to 9% of the men in the ACE study. Sex offenders in particular had significantly higher ACE scores than the general population. Likewise, Levenson, Willis, & Prescott (2014) administered the ACE questionnaire to 679 adult males who had sexually abused. Compared to males in the general population, sex offenders had more than three times the odds of child sexual abuse, nearly twice the odds of physical abuse,thirteen times the odds of verbal abuse, and more than four times the odds of emotional neglect and coming from a broken home.

Of course, not everyone responds to adverse and traumatic events equally. Authors such as Geral Blanchard have written on the understanding of post-traumatic growth, that ability not only to integrate traumatic experiences, but to find meaning from them and flourish as a result. Many clients who have sexually abused simply enter treatment looking to prevent further abuse and are not interested in an archeological expedition into their distant past. If there is anything the trauma field has learned, it’s that people who have experienced abuse need to discuss and move beyond it in their own way and in their own time. Sadly, there is far more high-quality research into recovery from abuse than recovery from sexual violence.

Perhaps the biggest question our field has yet to ask is how adverse experiences contribute to the areas that can make meaningful change seem unlikely to therapists and clients alike. It is tempting to think of the sequelae of abuse as being only things like distress and nightmares. It is easy to forget that therapy-interfering factors such as restricted affect, memory problems, relationship issues, and avoidance of situations that remind one of abuse (such as treatment for sexual aggression) are themselves trauma symptoms and not always attempts to avoid responsibility.

So how is it that our field is only now talking about trauma? Perhaps because we’re finally moving past thinking solely in terms of abuse-abuser hypotheses and understanding the nuances of adversity.

David Prescott, LICSW

Gwenda M. Willis, Ph.D., PGDipClinPsyc

PS. This blog was written with advice and contributions by Jill Levenson


             Levenson, J.S., Willis, G.M., & Prescott, D.S. (2014). Adverse Childhood Experiences in the Lives of Male Sex Offenders and Implications for Trauma-Informed Care. Sexual Abuse: A Journal of Research and Treatment. Avance online publication.doi: 10.1177/1079063214535819.

Reavis, J., Looman, J., Franco, K., & Rojas, B. (2013). Adverse Childhood Experiences and Adult
Criminality: How long must we live before we possess our own lives? The Permanente Journal, 17,

Monday, August 4, 2014

Sexual Abuse Prevention Blog - A focus on New Zealand

Introduction to the NEW Prevention Blog Series

What is your answer to the question, “What do you do for work?”  ATSA’s Prevention Committee hopes that your response is something like… “I work to prevent sexual violence.”  And if that person asks for more information, you can let them know that you care deeply about keeping communities, children and other vulnerable populations safe, so you have chosen to work with adults, adolescents and/or children who abuse.
ATSA’s Prevention Committee has reached out to the membership to uncover the unique collaborations that ATSA members are forming in their communities and explore what ATSA members are doing to prevent the first time perpetration of sexual violence.  In this first interview, the conversation created even deeper collaborations (e.g., Gwen Willis was invited to become a part of the organization’s board of directors).
As you read the blogs in this prevention series, we hope you will be as inspired as we have been by the work that ATSA members are doing in the world.  And if you are doing primary prevention in your community – working to prevent first time perpetration of sexual abuse – or know of an ATSA member who is doing this important work, please let us know.  You can reach us through ATSA at

ATSA members truly do have a unique perspective to offer.    

Joan Tabachnick and Karen Baker [Co-chairs of ATSA’s Prevention Committee]

Sex ‘n’ Respect: Prevention in New Zealand

“Consent is sexy, because it means both people are into it.”  That’s one of the many messages being delivered to thousands of New Zealand young people through Rape Prevention Education’s (RPE) sexual violence prevention programs.  While the majority of ATSA members’ work focuses on preventing repeat sexual violence, many members share a commitment to preventing sexual abuse before an offence is perpetrated.  This post is the first in a series from ATSA Prevention Committee members to showcase different prevention initiatives around the world. 
I recently met with Dr. Kim McGregor, Executive Director of RPE and some of her staff to learn more.  RPE is an Auckland based organisation with national prominence for prevention activities which include education and health promotion programs as well as catchy print and online media materials.  Delivered by a team of passionate professionals, many with a background in health promotion, theatre and/or survivors themselves, Sex ‘n’ Respect and BodySafe are examples of prevention in action in New Zealand.

BodySafe (ages 13 – 16) and Sex ‘n’ Respect (ages 16 – 18) comprise of a series of one-hour workshops delivered in high schools which share the motto of working with young people to promote respectful sexual relationships and prevent sexual violence.  Both programs utilise a mixture of discussion, stories, scenarios (e.g., about what is/isn’t sexual violence), worksheets, art and videos, with the content tailored to developmental level.

BodySafe focuses on educating students about consent using four steps: ask, listen, respect, reflect; and building participants’ confidence to negotiate consent in sexual situations.  In addition, BodySafe includes content about how to support people after sexual violence has occurred, exploring healing strategies, and developing bystander intervention skills.  Elements particularly well received by students include the use of role plays and scenarios.  The following quotation comes from a focus group ran as part of an external evaluation of BodySafe  (Dickinson, Carroll, Kaiwai, & Gregory, 2010, p. 43):

“The thing that really stands out for me was like the scenarios and we got to say what we thought of them, if it was rape or just sex”

A post program survey of 1104 students from ten schools found that 93% of participants were able to describe the legal definition of consent and 85% were able to describe what constitutes sexual violence.  When asked if BodySafe had changed the way students thought/acted in situations where they might be at risk, 48% responded “very much” or “extremely” (vs. 45% “moderately” or “a little” and 7% “not at all”; Dickinson et al., 2010).

Tailored towards senior high school students, Sex ‘n’ Respect includes workshops on consent and alcohol, gender stereotypes, and ethical action at parties – for example, identifying rights and responsibilities at parties and risk and safety management in social settings.  While RPE is clear that they do not support underage drinking and drug use, they recognize that both are common among young people in New Zealand.  A pre/post program survey administered to 250 students as part of an internal evaluation found decreases in rape supportive attitudes and significantly more students in the “action” stage of change (based on the Transtheoretical Model; see Prochaska, DiClemente, & Norcross, 1992) following program participation (Rape Prevention Education, 2012).

Consistent with US statistics, in New Zealand at least one in four females and one in eight males will experience some form of sexual violence in their lifetime, many before the age of 16 (Fanslow, Robinson, Crengle, & Perese, 2007; Fleming et al., 2007; van Roode, Dickson, Herbison, & Paul, 2009).  The high prevalence rates of sexual violence underscore an urgent need to prioritize sexual violence prevention in relevant social, health, and educational policy and ensure sufficient funding is allocated to the development and dissemination of effective sexual violence primary prevention activities.  While “what works” research in primary prevention of sexual violence is scarce, BodySafe and Sex ‘n’ Respect adhere well to principles of effective prevention programs identified in other fields (see Nation et al., 2003).  Perhaps most evident was a focus on fostering healthy, positive sexuality and relationships and attending to the developmental stages of different year groups.  For further information see and

Gwenda M. Willis, Ph.D., PGDipClinPsyc


Dickinson, P., Carroll, P., Kaiwai, H., & Gregory, A. (2010). BodySafe Programme Evaluation Report. Auckland: Massey University.

Fanslow, J. L., Robinson, E. M., Crengle, S., & Perese, L. (2007). Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women. Child Abuse and Neglect, 31, 935-945. doi:10.1016/j.chiabu.2007.02.009

Fleming, T., Watson, P., Robinson, E. M., Ameratunga, S., Dixon, R., Clark, T., & Crengle, S. (2007). Violence and New Zealand Young People: Findings of Youth2000 - A National Secondary School Youth Health and Wellbeing Survey. Auckland: The University of Auckland.

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention: Principles of effective prevention programs. American Psychologist, 58, 449-456. doi:10.1037/0003-066x.58.6-7.449

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102-1114. doi:10.1037/0003-066X.47.9.1102

Rape Prevention Education. (2012). Sex "n" Respect Parties Programme: Formative and Outcome Evaluation Report. Auckland: Rape Prevention Education.

van Roode, T., Dickson, N., Herbison, P., & Paul, C. (2009). Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse & Neglect, 33, 161-172. doi:

Sunday, July 27, 2014

The Methodological Debate

The aim of all research is to answer questions (Robson, 2011); but unfortunately the processes, as well as the answers, are not always that simple. There are different issues that can work to impede and/or complicate research within and between the hard sciences (biology, chemistry, physics, psychology and medicine) and the social sciences (criminology, sociology, social work and psychology[i]). Within social science orientated research, we are using social science in its broadest capacity here to discuss any and all research that examines human participants as well as the relationship between the self and society; and there is a vast array of different methodologies to choose from. I would firmly place sex offender research within this bracket. All research is about using tried and tested methodologies to answer specific questions, which means that you need to use the right methodology to answer the research question that you have to answer; this can sometimes be a bone of contention (Robson, 2011; Chambers, 1999).

Within any given research project there are often a diaspora of “interested” parties (for instance, funders, government bodies, other stakeholders) who directly or indirectly impact upon the research, when these “interested” parties also have a vested interest in the research (they are funding it, supplying data or access) they will get more vocal in promoting their viewpoint. All of these “interested” parties want the research to say and do different things, which can be quite frustrating (Robson, 2011; Davies, Francis & Jupp, 2011). Within sexual abuse research, these viewpoints can become difficult to navigate. There are a lot of “interested” parties; sexual abuse research does not exist in isolation and its outcomes can impact a swath of professions (police, probation, prisons, therapists, counsellors, community groups) and a number of issues (prevention, public protection, criminal justice, treatment, risk management), all of which can confine research practices.

In the main, when we talk about academic rigour and research with impact, especially in the Criminal Justice field, we are talking about inferential statistics and quantitative methodologies (NESTA). The prevailing view among both the academy and stakeholders, especially in government, internationally is that empirical, quantitative methodologies are the always the most appropriate approach to take when conducting research. Interestingly, there seems to be a step away from the traditional international governmental attitude to quantitative research and statistics within branches of government in Canada, where the emerging attitude seems to be that inferential statistics should not be used at all!

This international disparity throws up the real issue, that is that judgments are being made on the viability and impact of research based upon attitudes to methodology NOT, as it should be, attitudes to the whole research process and how the methodology sits in respect to the question. We should not play favorites with some methodologies, nor should we blacklist or ostracize others out of context. We need to make sure that the full methodological toolkit is available to us so that we can better develop and execute appropriate research; especially given that sexual abuse is a multi-disciplinary area and needs representation from different disciplines and methodologies. Ultimately, we should applaud all attempts to improve our knowledge rather than criticizing existing research because it couldn’t be of the highest quality. This is particularly true in an era when policy-makers are often unwilling to accept guidance from scientific findings. For instance, in the UK the Scottish (Chan et al, 2010) and English (Kemshall et al, 2010) of the limited disclosure scheme indicated a very low take up of the schemes, a lack of engagement with the schemes by the public and low levels of real world impact in policing terms all of which would indicate that the disclosure scheme was not doing what it was supposed to did not stop the government implementing it. A case of policy based evidence over evidence based policy maybe? There is no question that we should want the best methodologies; and we should want to best overall processes and options as well.

Not all methodologies suit all research questions, regardless of what some interested parties think, and using an inappropriate methodology will compromise the research study, impact upon the quality of the research as well as the outcomes (Robson, 2011). For instance,

-        Randomized Control Trials are often seen as the gold standard in evaluation research (Robson, 2011) and have been historically, and successfully used in social science research, and are now being used more often in criminal justice research (Duwe, 2012; Singer & Cooper, 2009), as criminology is starting to become more quantitative and experimental. However, from Larry Sherman and Richard  Berk’s domestic violence RCT, the first criminal justice RCT, to Grant Duwe’s (2012), both in Minnesota and both related to interpersonal violence interestingly, the use of RCTs is better able to polarize a group of researchers above and beyond any other methodology. The main concern with RCT’s is that they are inferentially powerful tools and should only be used accordingly, namely with a strong, variable and disperse sample. Therefore using an RCT to evaluate a well-established mainstream sex offender programme would be appropriate, relevant and useful; whereas using it to evaluate a pilot, specialized programme with 5 participants would not. This is not to say that RCT’s should not be used, but rather there are limits to the functionality, reliability, validity and results that it would produce; which would problematise the results and give a potential false negative.  In addition to the practical issues with RCTs there are also moral dilemmas as well as ethical issues relating to alternatives to treatment, public protection and offender care which although not limited to the sex offender field are very pertinent to it.

-         Using a purely quantitative approach to test the effectiveness and impact of an emerging paradigm. An example would be Circles of Support and Accountability (CoSA), where one would be better placed to use a multi-strategy design, a case study design, or even a purely qualitative approach to understand the processes and analysis the impact of CoSA, which, far from a simple treatment program is a complex social phenomenon (McCartan et al, 2014). That is to say, an RCT of CoSA should take place further down the line when a quantitative study with an appropriate (and sizeable) sample, but doing it with an unrepresentative or inappropriate sample would skew the results and problematise the research. Criticizing the methodology of existing studies too early in the research process (as has been the case in many spheres) misses the point and risks sending the wrong message to stakeholders.

The important thing to realize is that the choice to use a non-inferential methodology should not be seen as weakening the coherence of the research, its outcomes or impact just because you cannot give a level of significance to 0.05 or 0.01. If, through qualitative of case study research, you can demonstrate that a majority of your participants experienced a positive outcomes you are indicating that your research is having an impact, regardless of not having a level of significance. Instead you are showing that you are making an informed decision to use the correct methodology to answer your research question in the most appropriate light and that your results reflect the reality of what you are investigating. This means that the fringe benefits of research, like contributing to evidence based policy and practice, are realistic and grounded.

It is important to stay open minded to all forms of research methodology and use the one best suited to your research question, there are many ways to show success and impact so why decide to limit them.

Kieran McCartan, PhD
David S. Prescott, LICSW


Chambers, A. F. (1999). What is this thing called Science? 3rd Edition. Open University Press: Buckingham.

Chan, V., Homes, A., Murray, L., & Treanor, S. (2010). Evaluation of the Sex Offender Community Disclosure Pilot. Scottish Government Social Research. Retrieved December 6, 2010, from

Davies, P., Francis, P., & Jupp, V. (2011). Doing Criminological Research, 2nd Edition. London: Sage.

Duwe, G. (2012) Can Circles of Support and Accountability (COSA) Work in the United States?  Preliminary Results From a Randomized Experiment in Minnesota.  Sexual Abuse: A Journal of Research and Treatment, online access August 1st 2012 at:

Kemshall, H. & Wood, J., with Westwood, S., Stout, B., Wilkinson, B., Kelly, G., & Mackenzie, G. (2010). Child Sex Offender Review (CSOR) public disclosure pilots: A process evaluation. London: Home Office. Retrieved March 31, 2011, from

Robson, C. (2011). Real world research, 3rd Ed. John Wiley.

McCartan, K., Kemshall, H., Westwood, S., Solle, J., MacKenize, G., Cattell, J., & Pollard, A. (2014) Circles of Support and Accountability (CoSA): A case file review of two pilots. Project Report. Ministry of Justice.

Singer, L., & Cooper, S. (2009). Improving Public Confidence in the Criminal Justice System: An Evaluation of a Communication Activity. Howard Journal of Criminal Justice, 48 (5), 485 -500.

[i] Please note the ambiguous labeling of psychology as “hard” (i.e., cognitive psychology, vision and perception) and “soft” science (i.e., social psychology), this is because psychology is a wide and varied discipline that in different topic areas it is both.

Friday, July 18, 2014

Mandated Reporting of Child Sexual Abuse: Making a Good Call

Important Note:  This blog is a commentary about mandatory reporting laws in the US as they may apply to child maltreatment.  Mandated reporting laws in the US are state-by-state and too critical for any blog to offer conclusive advice to a wide audience.  Professionals might have reporting duties contrary to this discussion or beyond the scope of this opinion piece (e.g. vulnerable adults or Tarasoff duties).  Individuals should determine what the reporting requirements are in their respective jurisdictions, and comply with them accordingly.
When a mandated reporter receives credible information about criminal sexual conduct involving a child, reporting child sexual abuse may be an easy call.  But those cases are the exception.  Professionals often encounter ambiguous information about inappropriate sexual conduct, including non-contact sexual behaviors.  In many cases, a report to child protective services (CPS) is not actually “mandatory.”   When in doubt, why not just make a report, to be on the “safe side?”  Because for licensed mental health professionals with privileged communication, there is no “safe side.” When a client has a privileged relationship with a psychotherapist, all information that is not subject to reporting is protected by laws and ethics of client privacy.  There is not much ground in between.  
Despite the good intentions behind mandated reporting, there are competing concerns and legitimate controversies around mandated reporting, under both US and Canadian laws.  The US, Canada, Australia, and many other countries have some form of mandatory reporting.  Mandated reporters typically include teachers, mental health professionals, social workers, law enforcement, health care workers, and child care providers, among others.  In the US, 48 states have mandatory reporting laws that require specific professionals to report suspected child maltreatment.  As of 2012, 18 US states require everyone to report suspected child maltreatment.
When a privileged relationship exists, professionals need to consider whether their first duty is to client privacy and confidentiality, or to mandatory reporting.  Breaking client privacy, even with legal justification, is likely to be detrimental to the therapeutic relationship.  The decision to report, or not report maltreatment can be life-altering for children and for clients.  For professionals, an errant decision, in either direction, can have far-reaching consequences for many individuals, including themselves.
Privileged Communication and Mandatory Reporting
Physicians, clergy, psychotherapists, chemical dependency counselors, and others with privileged communication advance the public interest of providing professional expertise to society – making confidential services available to individuals who might not seek professional help for fear of reprisals.  The precepts of privileged communication are established by a combination of laws and professional ethics that seek a balanced outcome that both helps individual clients and serves the public interest.   Sometimes the balance is tenuous, but privileged communication is essential to many professional relationships.
When mandated reporters do not have privileged communication, mandatory reporting is often straight forward, and as long as individuals report in good faith, there’s little risk to reporters.  But confidentiality is foundational in most therapeutic relationships and therefore privileged communication is essential.  As a result, most licensed mental health professionals generally do have a privileged relationship with clients.  The US Supreme Court affirmed psychotherapist‐patient privilege in Jaffee v. Redmond, 518 U.S. 1 (1996). The requirements of this privilege are: (1) the communications must be confidential, (2) the therapist must be a licensed psychotherapist, and (3) the communications must occur in the course of diagnosis or treatment (Mitrevski, 2006). 
Some might view mandatory reporting as a moral responsibility, but when one is operating under the auspices of a professional license, they must understand the obligations and the limits of relevant laws and professional ethics.  The same set of laws and professional ethics that extend privileged communication to licensed mental health professions, also establish the requirements of mandatory reporting.   Professionals often learn about client conduct that ranges from sordid to illegal.   There are very few cases where licensed mental health professionals may violate privileged communication.  Mandatory reporting is one exception, and clients should be forewarned.  Because clients don’t share in the decision, and the outcome of a mandated report may be life-changing for clients, therapists must not get reporting wrong. 
When confidentiality attaches to a professional relationship, privileged information belongs to the client.  Clients need not invoke the right.  Mental health professionals have legal and ethical responsibilities to zealously protect privileged communication with their clients, even in forensic settings.  Regardless of whether clients understand their rights to privileged communication, therapists should respect and maintain both privileged communication and data privacy unless clients specifically waive those rights.   
Who is the Subject of Mandated Reports? 
Perhaps the most common confusion about mandatory reporting is not understanding who is the subject of a child maltreatment report.   Generally, the subject is not the alleged abuser but rather a specific child (or children) who may have been abused or neglected, might be in a harmful situation, or otherwise meet a statutory definition for reporting maltreatment.  There are two important considerations:  (1) in most states, reporting laws are predicated on suspected maltreatment by a parent, care provider, or someone in a position of authority; and (2) reporting requirements depend on whether suspected maltreatment is current or historical.  In keeping with these general guidelines, reporting laws in the US vary by state.  
Sexual Offenders and Mandatory Reporting
In providing treatment to those who have sexually offended, psychotherapists might be the first to discover new child victims.  When victims can be identified and CPS can be directed to them, there is little doubt about a professional’s duty to abused children.  It is the indistinct cases of child maltreatment that frequently create professional hazards for therapists.  These circumstances can occur repeatedly within sexual offender treatment settings because clients are typically expected to disclose their entire sexual history, including not only all victims, but in some cases every sexual transgression going back to puberty.  This exhaustive inventory can be a minefield for both clients and therapists – and for mandatory reporting.
Sexual offenders in treatment may lose privileged communication, either by court order or by being frightened, confused, or coerced into signing away their privacy rights through consents or a release of information.  One way that clients often unwittingly forfeit their rights to privileged communication is through the compulsory use of the polygraph – ostensibly for treatment purposes.  Such use is banned in Canada, but is popular in the US because of the “utility value” – getting clients to reveal victims or disclose other sexual misbehavior.  If privileged communication does not attach, such disclosures are at the peril of clients.  
When privileged communication is forfeited, treatment disclosures (not necessarily criminal) can carry significant risks to clients.   Certain disclosures can lead to extensions of treatment, probation consequences, arrest, new charges, additional incarceration, lifetime sex offender registration, public notification, residency restrictions, and perhaps even sensationalizing by media attention.  Information that clients reveal which is unprotected may contribute to a dossier for civil commitment.  Dancing around such disclosures creates a treatment paradox for both clients and therapists.  Always looming in the background is mandated reporting. 
The disclosure of unreported victims is a perilous process for both clients and their therapists.  If clients believe full disclosures could result in additional penalties or criminal consequences, there is a colossal disincentive to disclose unknown victims.   Obviously, there are few areas of sexual offender treatment that present a greater dilemma for clients and therapists.  But it is not without precedence.  Many professionals with privileged communication must reconcile conflicting ethical, moral, and legal responsibilities.  With few exceptions, the first duty for licensed psychotherapists is to the client sitting in the room.
If therapists need to report suspected maltreatment, write an assessment report, document progress in therapy or compliance with treatment requirements, disclosing more information about the client than is necessary to fulfill specific purposes is likely to be a violation of privileged communication.
Child Pornography and Mandatory Reporting
The use of real children in the production of child pornography (CP) is clearly child abuse.  As offensive as CP or pornography (broadly) is to many people, knowing that someone has viewed CP is not likely to be a mandated report.  Most CP depicts children whose identities are not known to either the viewer or the reporter.  If a child victim in CP is perhaps in another country, local CPS would not have jurisdiction.  Understanding that the subject of a maltreatment report is not the accused, a mandated report for CP typically does not make it past the thresholds of an identifiable child to which services can be directed.  
There are some disclosures of CP by a client that could indicate a mandated report.  An obvious example would be a known minor being involved in the production of CP.   Adults allowing young children to knowingly view pornography might also be reportable.   A teenager viewing porn on the Internet or looking at sexually explicit images on a smart device typically does not constitute maltreatment of a minor.  Children involved in sexting with other minors might be illegal, but generally is not maltreatment of a child.  While a case could be made that sexting by a minor is the “production and distribution of CP,” if it does not involve participation by an adult caretaker, it illustrates the need for reporters to use professional judgment.
If a client begins to disclose involvement with CP, it might be wise for professionals to interrupt and advise clients that there are limits to privileged communication, and that mandated reporting might apply to certain disclosures.  Bottom line, there are very few circumstances in which clients viewing CP requires mandated reporting.
Mandatory Reporting and Preserving Families
In about nine out of ten cases of child sexual abuse the abuser is a family member, relative, friend, or acquaintance.  When sexual abuse has already been identified and reported, often psychotherapists are already working with a family.  As a result, a therapist may be the point person on new allegations of child sexual abuse.  Professionals uncovering sexual abuse may have a sudden and urgent duty to many parties.  When this happens, mandatory reporting is not in question, but psychotherapists should also recognize the unique opportunity to support clients and their families in working with CPS. 
When skilled professionals have an established therapeutic relationship with a family, and new information about child abuse is discovered, therapists may be in a unique position to quickly ascertain the nature and extent of abuse, know the vulnerabilities of victims (and potential victims), be aware of salient risk factors, and facilitate an immediate safety plan that considers all factors.  Some CPS workers might argue that this is the domain of CPS, though experienced CPS workers usually welcome such a professional collaboration.  While reporters typically have to defer to directives from CPS, the most frequent outcome of many cases of substantiated child maltreatment is for the victim and family to be connected with a psychotherapist who has the expertise to address presenting problems.  When a skilled professional is already in place, the outcome of mandated reporting might very well come full circle.
Professionals should understand that not only sexual abuse, but its revelation, can tear at the fabric of families in different ways.  Often it is not the sexual abuse itself from which victims, offenders, or their families might never recover; sometimes the aftermath causes secondary abuse – unnecessary disruptions to the stability and strengths of the family.  Public policies should support a comprehensive, balanced approach to both primary and secondary prevention of child sexual abuse, to mitigate counterproductive consequences to victims and offenders, and whenever possible, support the preservation of families (Finkelhor, 2009).
Depending on who the abuser is, parents typically have the right and responsibility to be the “first responder” when it comes to protecting their children.  The right for government to interfere with parental rights is predicated on evidence that parents have failed to protect their children.   Even when an intervention is obvious and urgent, the solution might be to support a non-abusing parent(s) by marshaling appropriate resources to help ensure safety for their kids. 
The arts and science of the treatment of victims and sexual abusers have the capabilities of helping most families to recover from the damage of sexual abuse.  Child victims often have a greater capacity than adults to forgive abusers.  In all but the most severe cases of child maltreatment, children should not have to choose between the fear of being abused and the fear of losing otherwise valued relationships.  When family preservation is in the best interest of children, it is very empowering to victims, even children, for adults to ask them how we can support them, and let victims help guide their own recovery.  Supporting abused children in this manner is not only empowering, it can help restore a child’s trust in others, preserve families, build resiliency, and help turn victims into survivors. 
“Children should not have to choose between the fear of being abused and the fear of losing otherwise valued relationships.”
Summary, Suggestions, and Recommendations
The potential consequences for failure to report suspected child abuse is so unnerving for most professionals that there is a tendency to err on “the safe side” and report.   Hopefully, it is clear that there is no “safe side.”  It would be nice if there were a decision tree for mandated reporting, but reporting laws vary too much by jurisdiction.  There are, however, some basic tenets of therapeutic relationships that might be helpful:  professionals need to be aware of the jurisdictional nature of mandated reporting, they need to know their duties to client privacy, they must always be mindful of fiduciary responsibilities to clients, victims, and public safety, and be comfortable that therapists are not an arm of law enforcement. 
It is not lost on this author that there are some circumstances of child maltreatment that are so grave and urgent that mandatory reporting is not a question.  If dire circumstances warrant, the first phone call should not be to CPS; it should go to 911.
Because mandated reporting laws are jurisdictional, professionals might first consult colleagues about local requirements for mandated reporting, and the tenets of privileged communications within their profession.  If after consulting colleagues, professionals are still in doubt, they might be wise to consult with local CPS.  Without the need to initially disclose identifying information about the client, CPS workers are usually glad to advise whether a report is required.  As a former CPS social worker, I recommend that professionals who might be frequent reporters get to know one or more of the investigators who screen cases at your local CPS.  Not only are most CPS workers glad to educate colleagues, they want to work with other professionals to get reporting right, and direct appropriate services where indicated.   
As a final recommendation, when consulting with a CPS worker, keep a record of the conversation, including the date, time, specifics of the query, the name of the CPS person consulted, and the advice provided.  Such information may serve the dual purpose of a written report to CPS, which is required in some states.  It is not likely that CPS can assuage moral pangs about reporting decisions that are not intuitive, but when it comes to a directive on whether a report is mandated in a specific jurisdiction, local child protective services is golden. 
Appreciation goes to Jill Levenson for her contribution to this blog.

Post Script:  In the interest of sharing knowledge and clarifying mandated reporting requirements, readers are encouraged to post comments below.  Because mandatory reporting is regional, if leaving a question or comment, please note your jurisdiction. 
US Reporting Requirements, State by State
Behnke, S.H. & Kinscherff, R., (2002) Must a psychologist report past child abuse? APA Ethics Rounds, Vol. 33, No. 5.
Canadian Incidence Study of Reported Child Abuse and Neglect - 2008 Major Findings, Public Health Agency of Canada, Ottawa, Canada, 2010.
Finkelhor, D. (2009) The Prevention of Childhood Sexual Abuse, The Future of Children; Crimes Against Children Resource Center, Fall 2009, Vol. 19 (2) 169-194.
Kalichman, S.C., & Craig, M.E. (1991) Professional psychologists' decisions to report suspected child abuse: Clinician and situation influences. Professional Psychology: Research and Practice, 22(1), 84.
Mathews, B.P.& Bross, D.C. (2008) Mandated reporting is still a policy with reason: empirical evidence and philosophical grounds. Child Abuse and Neglect, 32(5). pp. 511-516.
Mathews, B.P. & Kenny, M.C. (2008) Mandatory Reporting Legislation in the United States, Canada, and Australia: A Cross-Jurisdictional Review of Key Features, Differences, and Issues Child Maltreatment, Vol. 13 (1), 50-63.
Miller, R.D., & Weinstock, R. (1987) Conflict of interest between therapist‐patient confidentiality and the duty to report sexual abuse of children. Behavioral sciences & the law, 5(2), 161-174.
Mitrevski, J.P. & Chamberlain, J.R. (2006) Psychotherapist-Patient Privilege, Journal of the American Academy of Psychiatry and the Law, 34:2:245-246.
Reamer, F.G., (2007) Protecting Privileged Information, Social Work Today, Vol. 7 No. 6.
Renke, W.N., (1999) The Mandatory Reporting of Child Abuse Under the Child Welfare Act Health Law Journal, Vol 7, 91-140.
Seto, M.C., Hanson, R.K., and Babchishin, K.M., (2011) Contact Sexual Offending by Men with Online Sexual Offenses, Sexual Abuse: A Journal of Research and Treatment, 23:124-145.  Originally published online 20 December 2010.$file/NSPI201243.pdf
Swoboda, J.S., Elwork, A., Sales, B.D., and Levine, D., (1978) Knowledge of and compliance with privileged communication and child-abuse reporting laws, Professional Psychology, Vol. 9(3), 444-457. 

Wednesday, July 9, 2014

Celebrity, Sexual Abuse and Societal Reaction

One of the biggest issues in sexual violence research, especially child sexual abuse research, is the lack of a coherent baseline. We read research like David Finklehor’s telling us that sexual abuse is, statistically, on the decrease (NY Times) while at the same time we are confronted with ever increasing media stories about the escalation of the reporting and unearthing of sexual violence cases.  The fact that sexual abuse has been under reported and under recorded historically, although this is starting to change in recent years (NSPCC), means that we never really, accurately,  know whether there has been an increase or decrease in recent years. This is stated even with the proviso that there are other data capture techniques which can be used in conjunction with police recording including, medical reports, social work reports and school reporting.  Hence, it difficult to truly get to grips with the nature, extent and reality of sexual violence in modern society and that is just focusing on westernised and developed countries, never mind developing nations. This knowledge vacuum has been, in part, replaced or supplemented with soft, experiential evidence provided in large part by the media, especially the television and print press. The ever increasing reporting of sexual abuse cases, particularly child sexual abuse cases, results in an ipso facto understanding, especially among the public and politicians, that there is more offending; for if offending was not increasing then there would be nothing to report? However, this is not necessarily the case, for as Greer & Reiner (2012) state the media can often misrepresent the abnormal as normal, therefore in their over reporting of unique cases they give the impression that there is more offending. Child sexual Abuse is a particularly potent case of this as it meets all the core components of newsworthiness generally containing, either, (1) a visible/spectacular act, (2) graphic presentation, (3) deviance, (4) sexual/political factors, or (5) individual pathology (Chinball, 1977).  The lack of a sexual violence baseline and issues in media reporting reach almost perfect storm portions with celebrity sexual offending.

In recent years, especially the last 10 years or so, there has been an onslaught in the reporting of, recording of and high profile media discussion of celebrity sexual abuse cases, on both sides of the Atlantic. It seems that since the Michael Jackson and Gary Glitter (Paul Gadd) cases in the late 90’s/early 2000’s there has been an increase in the reporting of sexual abuse by celebrities, historical and current, with a flood gate being opened. In the USA the big cases of Late has been the Jerry Sandusky, Steubenville, OH, and the Duke Lacrosse team, where in the UK there has been a number of historical (Jimmy Savile; Rolf Harris; Stuart Hall) and contemporary (Ian Watkins)individual perpetrator  cases as well as the suggestion of a cover up of sexual abuse by members of the government. This raises an important question, relating to media coverage and the lack of a baseline, has there actually been an increase in the rates of sexual abuse by celebrities or is it just that victims feel better able to report and police forces feel more confident to pursue these cases?  This piece will now discuss the central parts of the argument in turn,

(Sexual) Abuse by celebrities: There is no reason to believe that celebrities would be any more or any less susceptible to being perpetrators of sexual violence comparable to the ordinary members of the public from whence they came. However, what we do know is that celebrity is often linked with cognitive distortions, aspects or narcissism; where often times there whims maybe more likely to be catered to and aspects of transgressive behaviour (i.e., drugs, sexual promiscuity, minor offences, etc) either facilitated or tolerated. This means that being a celebrity can result in the person being treated differently than a “normal” non-celebrity individual. In addition, we know that “celebrity” sells papers and that there will be increased and in depth reporting of celebrity sexual abuse scandals.

Celebrity Culture and Celebrity worship: One of the big questions surrounding celebrity is why should we trust celebrities more than other people? Research has shown that Celebrity status holds a particular sway in modern society (McQuail, 2010). McCutcheon, Lange and Houran (2002) developed the “absorption–addiction” model of celebrity worship which consists of three levels;

1.       “Entertainment–Social” – whereby the individual discusses the behavior and attitudes of their favorite celebrity, this is a low level form of worship that is ultimately social and non-problematic.

2.       “Intense–Personal” – whereby the individual consistently thinks about their favorite celebrity, even at inopportune times, and this is an intermediate level of celebrity worship.

3.       “Borderline-Pathological” - whereby the individual is completely infatuated with their favorite celebrity and would do anything that they asked them to do. This is an extreme version of celebrity worship.

Additional research by North & Hargreves (2006) identified a fourth factor,

4.        “Deleterious Imitation” – whereby the individual is completely infatuated with their favorite celebrity and would go as far to mirror all their behaviors, including their illegal and transgressive ones. This, again, is an extreme version of celebrity worship.

Maltby et al’s research (2001, 2002, 2003, 2004, 2007) goes on to state that there is a relationship between celebrity worship, especially extreme celebrity worship, and mental illness. Individuals with tendencies towards extreme celebrity worship have been shown to have higher levels of vulnerability, personality problems, anxiety disorders, self harm and suicide. Which ties into issues surrounding celebrity and sexual abuse, for as we know vulnerable individuals are more likely to be targeted by sexual abusers, more susceptible to grooming and less likely to report abuse, especially in cases of child sexual abuse (Harrison, 2010). This becomes more problematic in regard to the reporting of these cases by victims because the victims who may report can be, certainly historically and less so now, be seen as problematic and unreliable witnesses by the police because of their vulnerabilities. The Ian Watkins case crystallized these issues with a series of unreliable witnesses (an ex-girlfriend who was a prostitute) as well as dedicated and obsessed vulnerable fans who where co-conspirators to his abuse who where in fact groomed and manipulated by him. The participation of vulnerable fans in abusive practices, although condemned by the press and the public (see the article and message board  responses below), ties in with research indicating that extreme celebrity worship, vulnerability and potential for delinquency all tie together (Sheridan, North, Maltby & Gillett, 2007).

Policing & celebrity sexual abuse: One of the main questions which has arisen as a result of the perceived increases in celebrity sexual abuse cases is the role of the police investigation. This is particularly salient in cases where the police are seeing to be complacent, complicit or absent from these cases. If you look at two cases from the UK (Jimmy Savile and Ian Watkins) you see evidence of a lack of police follow through at times, whereby people will report instances of abuse or suspensions to the police and they have not followed this up properly. In the Jimmy Savile investigation this lack of follow through can be explained, in part, by the societal attitudes to sexual abused at the time, Savile’s status as a celebrity with power and influence (i.e., closely tied to the establishment with high profile public supporters including high ranking police officers) and his personality all of which can been seen to intimate and dissuade investigations (Erooga, 2013). Over time, especially since the 60’s and 70’s, policing has changed and improved; however, the recent Ian Watkins case highlights that there are still issues with evidence indicating numbers reports to the police over a period of time and problematic online behaviour in open internet forums, which has resulted in an IPCC investigation into three police forces . There needs to be an open culture surrounding the policing of celebrity transgression, whether it is minor or serious, with police forces not being afraid to make difficult decisions, but as always these need to be based on evidence because false allegations can be as damaging as real ones (i.e., Michael Le Vell).

The recent high profile discussions of celebrity sexual abuse are important conversations to have, but we need to have them in the context of the role of celebrity in society, vulnerability amongst victims of this abuse and how to better prevent this abuse; how do we realistic manage and respond to celebrity in the culture of celebrity that we live in? The one thing that we need to be careful of is knee jerk political and public reaction, especially in terms of policy for as we have seen in the past with sex offender disclosure and now with anti-pornography legislation, this needs to be coherently through through.

 Kieran McCartan PhD


Chibnall, S. (1977). Law and Order News. London: Tavistock.

Erooga, M. (2013). The SAVILE Scandal: beginning to understand. NOTA News, 70, 8 – 11.

Greer, C., & Reiner, R (2012). Mediated mayhem: media, crime, criminal justice. In Maguire, M, Morgan, K and Reiner, R (Eds.). The Oxford handbook of criminology (5rd ed.), (376-416). Oxford: Oxford University Press.

Harrison, K. (2010). Dealing with High-Risk Sex Offenders in the Community: risk management, treatment and social responsibilities. Willan: Cullompton.

Maltby, J., Day, L., McCutcheon, L. E., Gillett, R., Houran, J. and Ashe, D. D. (2004). Personality and coping: A context for examining celebrity worship and mental health. British Journal of Psychology, 95: 411–428.

Maltby, J., Houran, J., Lange, R., Ashe, D. and McCutcheon, L. E. (2002). Thou shalt worship no other gods – Unless they are celebrities: The relationship between celebrity worship and religious orientation. Personality and Individual Differences, 32: 1157–1172.

Maltby, J., Houran, M. A. and McCutcheon, L. E. (2003). A clinical interpretation of attitudes and behaviors associated with celebrity worship. Journal of Nervous and Mental Disease, 191: 25–29.

Maltby, J., McCutcheon, L. E., Ashe, D. D. and Houran, J. (2001). The self-reported psychological well-being of celebrity worshippers. North American Journal of Psychology, 3: 441–452.

McCutcheon, L. E., Lange, R. and Houran, J. (2002). Conceptualization and measurement of celebrity worship. British Journal of Psychology, 93: 67–87.

McQuail, D. (2012). Mass Communication Theory, 6th Ed. London: Sage Publications.

North, A. C. and Hargreaves, D. J. (2006). Problem music and self-harming. Suicide and Life-Threatening Behavior, 36: 582–590.

Sheridan, L., North, A.C., Maltby, J. and Gillett, R. (2007). Celebrity worship, addiction and criminality. Psychology, Crime and Law, 559-571.