Thursday, July 21, 2016

(re)Integration, Risk Management & Public Protection

Recently, I have been in conversations with academics and professionals about the effectiveness of offender reintegration programmes, risk management and public protection. There seems to be an idea that “risk management” is an evil concept and a by-line for punitive state control, which is worrying. A notion that public protection means a dictatorial system, with no flexibility, originality and a preserved need for rhetoric as well as justification – which is also concerning. The most disturbing  though, which I have heard from professionals on both sides of the Atlantic, is the notion that reintegration is returning offenders to communities for them to get kept separate from said communities and not being allowed to interact with them because of risk management and public protection concerns. Which creates a perfect storm; for a lack of integration, support and partnership working can result in an increased likelihood of re-offending. The question that I have been pondering is whether we have become jaded by the system and that we cannot see the interrelated beneficial outcomes of these terms?

The big debate is reintegration versus integration. I think that these are two different things that often get confounded. The idea behind reintegration is to return someone to the same point in a situation that they were at before they were removed from that situation; but that is not what we want with offenders or sex offenders. We want to return them to society to a new, improved more adaptive situation. We do not want them falling into old habits, bad ways or being more likely to reoffend. We want them to develop good relationships, new relationships and positive social capital. Therefore, it’s not really reintegration as much as integration. It’s integration informed by treatment, risk management, social support and adaptive thinking. This is important because this perspective means that sex offender integration is a  group activity involving the criminal justice system, the offender and the community; it is not simply “review, release and go,” instead it's more “review, release and support.”

Successfully integrating offenders into communities means that risk management is important, as it’s a proactive and forward-looking endeavour rather than a reactive and negative one. Risk management is not, and should not be, a one-size-fits-all model. Different individuals pose different risks and need different responses; additionally, over time, the same individual's risk can change and therefore so too will their risk management needs. Risk is fluid and, therefore, so should be risk management! However, there is a view that risk management is fixed, bureaucratic, autocratic and unchanging. If our role is to integrate ex-offenders, especially sex offenders, with all the labels that they bring with them, we have to change this view of risk management.  We need risk management to work on an individual level so that offenders can get the best from the system and increase their likelihood of returning to the community and living offence free. 

Both offender integration and positive risk management tie in with ideas of public protection. Generally when we talk of public protection in respect to sex offenders we are talking about proactive policing, social work, and probation; we are talking about how the system can limit the freedom of known offenders to protect the public from victimisation. Again, this form of public protection is not necessarily a bad thing in regard to certain offenders, but it cannot be a blanket approach, it needs to be a more individually driven approach that takes into account the individual offender. As risk management can be proactive in helping sex offenders integrate into communities post release, so too can public protection strategies, especially those that involve the community, multi-agency working and reflect the notion that people can change.

We have to reconsider the interrelationship between integration, risk management and public protection; they are not separate (but interrelated). They are not always negative (they can be, but they can be positive too). They can give us freedom to help offenders re-entering communities in a productive, individualistic way (so move away from one-size-fits-all models to more individualistic ones). If we as the people who work with these terms, concepts, guides, and frameworks on a daily basis see them as negative, undermining and problematic, imagine the impact that this has on the offender that has to live by them; therefore it would be worthwhile to reconsider how, why and in what way we use them.

Kieran McCartan, Ph.D

Friday, July 15, 2016

Yoga informed treatment

The topic of using yoga as an adjunctive treatment for traumatized people has recent come up on ATSA’s listserv and at a number of conferences (e.g., the National Adolescent Perpetration Network, the Massachusetts Adolescent Sex Offender Coalition). In case it helpful, I am summarizing some recent discussion for this blog.

In 2014, Bessel van der Kolk and his colleagues produced a fascinating randomized controlled trial on a specific kind of yoga practice for people who have experienced trauma. There has been increased empirical attention to the use of movement therapies such as yoga and tai chi, as well as mindfulness and meditation in recent years, and many within these fields have noted that the work of van der Kolk and his colleagues has moved the field forward a little more. Despite this empirical attention, it may be more helpful to consider yoga more as a source of practice-based evidence than an evidence-based practice. By this, I mean that yoga is clearly not for everyone; in the experience of many, when it is helpful it can be extraordinarily helpful. If it’s not for you, it’s probably best not to practice it.

My involvement with trauma-sensitive yoga (TSY) in treatment goes back about 10 years to when I was overseeing the front end of treatment at Wisconsin’s civil commitment program, Sand Ridge. Much has changed there since, but at the time I was frustrated by the fact that we had clients in treatment who could do all the cognitive exercises in the world and run groups about cognitive skills better than many facilitators. The problem was that they could examine their cognitions and actions after the fact, but they just couldn’t observe them in the moment as they were happening.

In many cases, they came by this honestly. Years of abuse, neglect, and other trauma, sometimes before they could even talk, left them in the states you might expect: scanning their environment for threats, scanning the staff for evidence of bad intent, and never scanning themselves. One ATSA-lister quipped with me that this apparent absence of curiosity in many of our clients can seem to disprove the Socrates dictum that the unexamined life is not worth living. In fact, it seems that many of our clients have never had the opportunity to develop self-observation skills because they were too busy surviving.

On top of this, it has become obvious to many of us treating adults and adolescents that not only do our clients very often not examine their thoughts and actions, many of them outright hate their lives, their futures, their sexuality, and their own bodies. In the programs where I’ve worked, this has been evident way beyond the periodic self-injurious behaviors that programs often experience. A turning point for me was the day that a client who knew more about cognitive-behavioral treatment than most of the clinicians left group and impulsively assaulted a uniformed staff. He was as surprised as anyone by the assault; in essence, he knew the words but not the music about managing his behavior.

Rob Longo, Kevin Creeden, John Bergman and I worked together some years back on using brain-based interventions in the treatment of trauma and violence. Reviewing the research inevitably led to an interest in yoga and other movement therapies as a means to deepen the impact of therapy. In my case, I joined up with Bessel van der Kolk’s JRI group and became one of their first certified instructors. We’ve used a specific form of trauma-sensitive yoga (see www.traumasensitiveyoga.com) in our programs, on and off, for some time now with positive overall results. I mention some key points below.

Yoga, like other movement therapies and many forms of meditation can be an excellent means by which people can develop the self-observation skills that will make it easier to access treatment. Many have found it to be a transformative start to reclaiming their bodies and their lives. I park it under the responsivity principle generally, but note that for some people it can have dramatic effects beyond being merely an adjunctive treatment.

Trauma-sensitive yoga generally eschews some of the more obvious pitfalls of doing yoga in settings such as those in which many of us work. Simply bringing in a teacher and hoping for the best is unlikely to work out very well. Not only can many of the usual trappings actually become distracting from its purpose (lavender oil, eye pillows, etc.), some of them can be triggering (e.g., the use of straps and many of the “poses” such as happy baby and down dog).
 
Ultimately, key elements in the way that we use this kind of yoga include:

1)      Just noticing…

2)      …and practicing making choices based on what one notices (e.g., if stretching your neck feels different on one side or another, you might try altering how how you stretch)

3)      An investigation of each experience

4)      Being highly sensitive to dosage. Getting in touch with body sensations can be much scarier than most of us realize. For people who are traumatized, even a focus on the breath can be triggering.

5)      This is judgment free: This is not about trying to do anything better, comparing yourself to others, etc.

6)      This kind of yoga should never, ever be compulsory. Directing people to do yoga without it being completely their choice is itself an abuse dynamic. All too often, we’ve been stymied by the past experiences of clients who have been hospitalized and gently coerced into yoga by staff who remind them that it will help them earn points, levels, privileges, etc. Bad practice.

My colleague David Emerson and I have noticed that although we’ve worked with similar groups of adolescent clients we tend to use different formats. I have no problem teaching classes of 35-40 minutes, while he often gets better results from very brief individual interactions. I’ve chalked this up to small differences between us more than differences in clientele.

I urge all readers to look further into the possibility of movement therapies and meditation practices as adjunctive treatments for trauma!

David Prescott, LISCW
 

 

Thursday, July 7, 2016

Prevalence of Perpetration


There is no simple answer to the question, “How many sexual crimes are committed each year?”  It is extremely difficult to find any reliable measure for many reasons – sexual crimes are rarely reported; the definitions of sexual assault, rape, child sexual abuse, statutory rape, and other crimes vary from state to state; and how sexual crimes are recorded may vary from one municipality to another and even from person to person.  Even with these challenges, current measures of the incidence and prevalence of sexual violence provides important information necessary for better policies, more effective interventions, and evidence based prevention programs.   

The SOMAPI report from the DOJ SMART Office begins with a chapter by Jane Wiseman that provides an excellent overview of what is known about the incidence and prevalence of sexual crimes in the US [http://smart.gov/SOMAPI/sec1/ch1_incidence.html].  The chapter documents the wealth of information from a variety of different data sources including the Uniform Crime Report (UCR) data to the Federal Bureau of Investigation (FBI), National Crime Victimization Survey (NCVS) data, National Violence Against Women Survey (NVAWS), among many others.  Most of these sources report out information about the extent of victimization.  For example, incidence is defined as the number of separate victimizations and prevalence is defined as the number of people within a demographic group (e.g., women or men) who are victimized during a specific time period.  And advocates will quote statistics that state how many women are sexually assaulted in their college years (one-in-five; Not Alone) [ https://www.notalone.gov/assets/report.pdf] or how many children are sexually abused before the age of 18 (one-in-five girls and one-in-20 boys; Finkelhor) [https://victimsofcrime.org/media/reporting-on-child-sexual-abuse/child-sexual-abuse-statistics].

However, given the growing focus on preventing the perpetration of sexual abuse and in particular ATSA’s focus on what we know about those who cause the harm, what do we know about the incidence and prevalence of sexually abusive behavior? 

Through NEARI Press, David Prescott, Steve Bengis and I reviewed a 2013 JAMA article by Michele Ybarra and Kimberly Mitchell on the prevalence of sexual abuse perpetrated by boys and girls. The authors found that 1 in 10 youths (9%) reported some type of sexual violence perpetration in their lifetime.  And for those who did perpetrate some form of sexually abusive behaviors, 16 years was the most common age of onset.  Here is the link to that NEARI Press commentary:
http://www.nearipress.org/newsletter-archive/177-prevalence-of-sexual-abuse-perpetrated-by-boys-and-girls.

I have also looked into this question during my fellowship with the DOJ SMART Office and found that in the US, we rarely ask these questions about perpetration but in other countries, these questions are asked -- especially in war-torn countries. I would recommend an article by Jewkes, Fulu, Roselli & Garcia –Moreno that discusses this from a global perspective.

If we begin to look at the rates of perpetration (much higher than most people would expect, especially if the broader definition from public health is used) then we see the importance of early intervention with all youth, and especially with boys at the middle and early high school ages.

As ATSA members, we are constantly trying to say that one-size-does-not fit all; that people who abuse are people we know, etc.  If we begin to ask question about the rates of perpetration and begin using these statistics, it highlights a key role for those who work with offenders and youth with sexual behavior problems.  We have a unique skill in identifying behaviors that are healthy and also those of concern.  And even more, as clinicians, probation and parole officers, and other professionals in this field, we know how to talk about our concerns and also how to confront behaviors that may give us some concern.  As the focus of prevention slowly shifts towards preventing the perpetration of sexual harm, there is a growing need for these important skills. 


Joan Tabachnick

Friday, July 1, 2016

David Lee talks sexual harm prevention with Jon Brown


People throughout the world are taking action to prevent sexual violence.  As a global problem, we need to learn from each other to develop and implement prevention strategies and approaches. ATSA’s Prevention Committee includes members from all over the world, including Jon Brown from the National Society for the Prevention of Cruelty toChildren (NSPCC) in the United Kingdom.  I recently had the opportunity to interview Jon about sexual violence prevention work in the United Kingdom (UK).

Drawing on knowledge from his work to prevent child sexual abuse and from the ATSA Prevention Committee, Jon chairs the prevention committee of the National Organization for the Treatment of Abusers (NOTA).  Jon describes the committee as moving toward primary prevention to “get on the front foot and address the drivers of sexual abuse and sexual violence before they actually manifest themselves in crimes against adults and children.” In July 2016, NOTA will be hosting a prevention conference where prevention experts will explore how to build primary prevention effort. In addition NOTA is creating public events and facilitating conversations about primary prevention of sexual violence.

Jon is committed to building a prevention infrastructure in the UK.  He says that “we need to translate the momentum that is beginning to grow into a real national strategy.” In order to support the investment in prevention it is necessary to recognize that “if we can intervene early and can actually prevent abuse in the first place, then you are saving huge amounts of money. Obviously you are saving huge amounts of distress and trauma to the victims, but importantly, to government, you are saving many millions of pounds a year.”

Jon is working toward establishing prevention centers throughout the UK to provide advice and information to local providers and community members on how to prevent sexual violence.

Learn more about Jon’s work to prevent sexual violence by watching the full interview at https://youtu.be/lbGIO3TeQqI


David S. Lee
Director of Prevention Services
Manager, PreventConnect
California Coalition Against Sexual Assault (CALCASA)

 




 
 
 


 

Friday, June 24, 2016

Q & A with Steven Gillespie & Tom Squire on "An Evaluation of a Community-Based Psycho-Educational Program for Users of Child Sexual Exploitation Material”.



Gillespie, S. M., Bailey, A., Squire, T., Carey, M. L., Eldridge, H. J., & Beech, A. R. (2016). An Evaluation of a Community-Based Psycho-Educational Program for Users of Child Sexual Exploitation Material. Sexual Abuse: A Journal of Research and Treatment.

Online sexual offenders represent an increasingly large proportion of all sexual offenders. Many of these offenders receive noncustodial sentences, and there is a growing need for community-based interventions. The aim of this study was to evaluate a psycho-educational program for community dwelling users of child sexual exploitation material (CSEM). A total of 92 adult male participants completed self-report measures at pre and post. A subset of participants also completed measures after a follow-up period. Results suggested benefits across depression, anxiety, and stress; social competency, including locus of control and self-esteem; and distorted attitudes. Furthermore, these effects remained 8 to 12 weeks following program completion. Our results suggest that CSEM users are amenable to treatment in the community and that there are beneficial outcomes in affective and interpersonal functioning following psycho-education. These factors represent treatment targets for sexual offenders and are recognized risk factors for contact sexual offense recidivism.


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

SG/TS: The Lucy Faithfull Foundation has been running the Inform Plus program for nearly ten years now and we were keen to evaluate its effectiveness.  There is an increasing number of men being investigated for child sexual exploitation material (CSEM) offenses, and many of these men want to seek help. However, there are few programs available that offer such help, and limited knowledge on what kind of programs might work with this group.

What kinds of challenges did you face throughout the process?

TS: The biggest challenge was extending the programme from 10 to 11 sessions to enable participants to complete the various measures pre- and post-programme.  This required the content of some sessions to be shifted forwards or backwards by one session, and all staff, working at different sites, had to be appropriately briefed.

SG: The evaluation involved collecting data at various different sites, from ten different groups running at different times within a twelve month period. Data was also collected at three different time points (pre, post, follow-up). Typically I run experimental paradigms so this was a very different project to be involved in. Another difficulty was identifying a suitable control group, and in the end this wasn’t possible. This is one area where our work can be built upon in the future.

What kinds of things did you learn about co-authorship as a result of producing this article?

SG: While my background is purely academic, my co-authors from the LFF have a wealth of practical experience with this client group. During the writing of the report these differing perspectives complemented each other nicely. For example, it would be easy to think that over the course of the program events in the clients’ lives might naturally have started to settle down with time. However, clients might be recalled for interview, receive court dates or appear in court at the same time that they are participating in the program. Set against this background it was interesting that we found reductions in depression, anxiety and stress that might not simply reflect the passing of time.

TS: In terms of producing this article, I am utterly indebted to Steven – without his involvement I wouldn’t be writing this now.  With regard to the actual research, we had some interesting discussions about interpreting the data, and it felt productive to combine the clinical experience of staff at LFF with Steven’s academic insights. 

What do you believe to be to be the main things that you have learnt about treatment for Users of Child Sexual Exploitation Material?

SG: Intervention with low risk offenders can pose various dilemmas, including whether or not intervention will help, or even hinder, the clients. Our findings suggest that short, low intensity psycho-educational programs could prove beneficial with this kind of sample. Our results also suggest that these men are amenable to treatment in the community, which is important given that a large number of CSEM users may not go to prison.

TS: Our research lends weight to the idea that psycho-education, as part of a relatively short intervention, is an effective approach to take with CSEM-only offenders.  In addition, the research is congruent with literature about the benefits of group-based intervention and the importance of the facilitators’ style and approach.  

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

TS: We are at our best when we engage with the whole person and all their needs.  Clients must never be reduced to no more than the embodiment of risk, however that might be classified.  A philosophy of purposeful collaboration and enquiry should be our guide - our clients have much to teach us.

Steven Gillespie, Ph.D, is a Lecturer in Forensic Psychology in the School of Psychology at Newcastle University.

Tom Squire is Clinical Manager at the Lucy Faithfull Foundation.


Friday, June 17, 2016

Alcohol, Vulnerability, and Sex = Rape


“Some people see vulnerability and become exploitive;
others see vulnerability and become protective.  This story saw both.”

On January 17, 2015, Stanford freshman Brock Turner and a young woman both ended up at a college frat party.  The next morning he was in jail, she was in the hospital, and they were both trying to figure out what happened.  This was not the alcohol-infused sexual encounter between consenting young adults, which happens with tragic frequency.   They were both drunk, but didn’t know each other.  There are no crisp laws for when blood alcohol content (BAC) is too high for someone to consent to sex, so let’s agree that when at least one party has reached the not-so-scientific threshold of ‘shitfaced,’ they should not engage in sex.  The limit of BAC to legally drive a car provides a reference point for intoxication.  It’s likely that, at least mechanically, having sex is less complicated than operating a motor vehicle, but in this case, Turner’s BAC was twice the legal limit for driving; her BAC was three times.  Without testing, how can one know if potential sexual partners are shitfaced?   A clue might be when one individual has passed out.

To avoid further victimization, the media has protected her identity, but to try to elevate her above the label of ‘victim’ or a simple pronoun, I’ll offer the small dignity of a capitalized ‘She.’

Sexual abuse is epidemic in the US and pervasive on college campuses; so why did this story catch international attention?  In part because of some classic themes that illustrate disparities in our criminal justice system: the offender was white, attending a prestigious college on an athletic scholarship, and he came from a family of means that afforded him a top legal defense.  But what truly propelled this story into viral status were three other factors: the extraordinary intervention of bystanders, an amazing victim impact statement, and unexpected leniency in sentencing.

When it comes to interpersonal sex, there must be no confusion about consent; but when alcohol is present, consent is always muddied.  Alcohol is not an excuse for rape; it just happens to be a contributing factor in half of all rapes, particularly on college campuses.  When so much about sex happens under the ‘control’ of primitive parts of the brain, it would seem people cannot afford to have any impairment to executive functioning.  An expert at trial testified that one does not have to be unconscious to not remember having sex; they need only be drunk enough to experience a blackout.  This impaired state can facilitate an illusion of consent – with tragic outcomes for both parties.

If She was functioning in a blackout when the sexual encounter began, She was unmistakably unconscious when the sexual assault was interrupted by Stanford graduate students Peter Jonsson and Carl Fredrik Arndt.  As they were riding their bicycles near the frat house at 1 am, they might have ignored two people having sex outside on a Saturday night, but the location by a dumpster seemed odd and when the woman appeared unresponsive, they confronted Turner, who ran.  While Arndt checked on the victim, Jonsson gave chase, tackled Turner, and held him until police arrived.    Some people see vulnerability and become exploitive; others see vulnerability and become protective.  This story saw both.

This contrasting response to vulnerability illustrates curious questions about the flaws and virtues that are ubiquitous in human nature – and typically even found within the same individual.  One treatment target for those who have sexually offended is empathy building.  But a question remains: if when exposed to vulnerability, one is not instinctively protective, can one learn to be protective, or at least not exploitive?  How innate or malleable is this potent, if sometimes unfortunate human characteristic?  

An equally compelling takeaway from this story is how some victims become survivors while others remain victims.  Whether She had the resiliency to tell her story, or found resiliency by telling her story, She undoubtedly has inspired an untold number of victims of sexual abuse to come forward, ask for help, and seek justice.   The world won’t know her name, but millions of people will remember that She wrote a powerful, unfiltered narrative of her journey – from gradually discovering being sexually violated, to enduring the trial of her assailant.  Her full (7,200 word) victim impact statement can be found on the Internet.  There is an edited narrative of her poignant story on YouTube.  Her evocative words drew a heart-felt response from US Vice President Joe Biden.  While the Internet facilitated millions to read her poignant reflections, the Internet will also never forget what Brock Turner did.  His life is in tatters.

A jury found Turner guilty on three felony counts.  He was eligible for 14 years in prisons, prosecutors asked for six years, probation recommended four to six months in county jail.  Turner was sentenced to six months in jail (less with good behavior).  Prison sentences are expected to strike an equitable balance between public safety, punishment, and rehabilitation.  However, by international standards, the US is a leader in both the use of prisons for punishment, and in the length of prison sentences.  Public opinion might be divided on where this sexual assault falls on the heinous scale, but overwhelming public opinion is that six months in jail was a miscarriage of justice. 

Judge Aaron Persky’s effort to spare Turner the “severe impact” of a long prison sentence may have been well intended but might have ultimately backfired.  It fueled an impeachment petition against the judge and probably aggravated public backlash against Turner.  If Turner can avoid rape or assault while incarcerated, any jail time might be the least impactful of the life-changing consequences of his offense.  He is now a convicted felon, subject to lifetime registration as a sex offender, he forfeited a prestigious education, his aspirations for being a world class competitive swimmer are shattered, and any glorious career ambitions are all but over.  Sometimes people can be held accountable for personal violations, outside of the criminal justice system, and without long prison terms.

Sexual assaults and binge drinking on college campuses are rampant.  Reported rapes on college campuses are a fraction of all sexual violations between students.  Some college students are falsely accused of rape, and in one high-profile case the entire Duke Lacrosse Team paid a high price for false allegations.  When so much is at stake for young women and men, we can’t afford to get this wrong.  It’s a bit ironic that college campuses, with their vast educational resources, have not been more effective at reducing the prevalence of sexual violations between students.

According to recent reports, Peter Jonsson and Carl Fredrik Arndt have yet to meet the woman who they rescued.  But She wrote that, “I sleep with two bicycles that I drew taped above my bed to remind myself there are heroes in this story.  That we are looking out for one another.”  Hopefully this compelling story will inspire other bystanders.  Perhaps we will make real progress when we truly understand that justice is neither served when victims remain shamefully silent, nor when offenders can never recover.  Neither victims nor offenders want to be forever remembered for the most regrettable times of their lives.
Jon Brandt, MSW, LICSW
When will our consciences grow so tender that we will act to prevent human misery rather than avenge it?”   Eleanor Roosevelt, February 16, 1946

Friday, June 10, 2016

The Lifelong Damage Labels Carry


Juvenile sex offender — the term abounds in courtrooms, headlines and even among professional treatment and welfare circles. In five syllables, kids go from curious 8-year-olds and teenagers hopped up on hormones to social deviants. It is misguided to define any human by a single action, but when we refer to children as sex offenders the consequences are particularly destructive.

In the United States, federal law mandates that minors adjudicated for sexual offenses be subjected, alongside adults, to “sex-offender” registration and notification requirements. Numerous studies over several decades now have definitely confirmed registration does not deter first time offenses or reduce recidivism — in any instance. Public health officials found in a study published last year that rather than improving public safety, this practice, “communicates constantly and in a variety of ways that [registered] youth are dangerous, feared, worthless and have no real future.”

After leaving my job as a juvenile public defender almost a decade ago, I spent years traveling the country to interview people who had gone on registries for things they did as kids, from playing doctor, streaking or Romeo and Juliet romances to committing serious sexual harm. I sat in their living rooms, with their parents and children of their own, as they described what it’s like to go through the world as “juvenile sex offenders.” They had been physically assaulted, fired from jobs, driven out of schools. One young man I met with would later tell a reporter that I was the first person who told him he wasn’t a sex offender. He’d been on the registry for almost half of his life at that point.

Intended or not, the term sex offender invokes a visceral response in the public. Meanwhile, just the word offender implies that the person intentionally caused harm and offended more than once. Many of these kids were themselves victims of abuse and didn’t even know at the time what they’d done was wrong. And empirical research shows the vast majority — more than 97 percent — have never and will never reoffend sexually.

Even using the term sex-offender treatment is harmful. By framing it as “sex-offender treatment,” we overlook that when it comes to kids their behavior has very little to do with sexual pathologies. Beside, we don’t dismiss people with other psychological symptoms, such as depression or anger, with a single noun; and we shouldn’t in this instance either. In a new study to be published later this year, public health officials surveyed more than 220 kids in treatment for sexually intrusive or abusive behavior. Compared to those who have never been subjected to registration, youth who currently or have previously had to register as a sex offender report significantly higher rates of considering and/or attempting suicide.

As the director of the Center on Youth Registration Reform, my work focuses on youth, my goal is to eliminate the practice of putting minors on registries; but to do that we have to challenge the public narrative around youth sexual behavior. That starts with being more deliberate in conversations on this issue and not using the term sex offender to describe children — under any circumstance. (I normally try to avoid the term sex offender altogether, but I’ve left it in this article so readers can see just how often it creeps in.)

Researcher Sharon Denniston’s recent doctoral dissertation measured the impact juvenile registration has on adult depression. She found that it’s not the legally imposed restrictions but rather the sex-offender label that often has the greatest psychological impact. Interestingly, those on non-public registries suffer from even higher depression rates than those on public registries, which suggests how deeply youth internalize being branded.

In the media, headlines teem: “New therapy proves effective for juvenile sex offenders,” “States Slowly Scale Back Juvenile Sex Offender Registries,” “Are We Properly Dealing with Young Sex Offenders?” What we should be asking is whether we’re properly educating youngsters about sexual boundaries, whether we’re giving child sex abuse survivors the resources they need to heal and whether we’re doing permanent damage because we’re too lazy to say a few extra prepositions. Childhood is about second chances. When we label kids we rob them of identity — and, even worse, hope. We make it is easy for society to demonize and treat them as other.

Moving forward, we must be more vigilant of the words we choose, always careful not to reduce a person to an action or a nuanced behavior to a simplified pathology. And the change must start with us — treatment providers, child welfare experts and juvenile justice professionals. As a body we must pressure the media to reconsider how it uses the term sex offender; if the public discourse can be redirected, eventually sentiments will begin to shift as well. And maybe then we will be able to see our children for what they really are: children.

Nicole Pittman, esq., Director of the Center for Youth Registration Reform at Impact Justice, has been working to remove kids from registries for more than a decade, through legislation, law and creating awareness. Also a juvenile attorney, she is a Stoneleigh and Rosenberg Leading Edge fellow.