Sunday, March 29, 2015

In 500 words (or less): Talking Desistance from Sexual Offending with Danielle Harris, PhD


“Desistance” refers to the slowing down, de-escalation, or stopping of offending. Although the term is relatively new to those who study sexual aggression, the phenomenon has been a staple of criminological research for two centuries (Laws & Ward, 2011). The observation of “natural desistance” or aging out (when one stops committing crime as they get older) is a key component of the criminal career paradigm. Some researchers, in fact, argue that no variable (e.g. race, gender, marital status, employability, educational achievement, parenthood, psychological treatment, or therapy) either combined or alone, accounts for the decline in crime better, or more completely than does age.

One reason why desistance is such a new concept for people who have committed sexual offenses is the enduring assumption of inevitable recidivism (Willis, Levenson & Ward, 2010). There is a persistent belief among many practitioners, policymakers, and members of the public that sex offenders seldom if ever stop and that when they are released from custody, recidivism (or “failure”) is the expected result.

The fact that many men convicted of sexual offenses share more similarities than differences with generic, nonsexual criminals has been the subject of much recent research (Harris, Smallbone, Dennison, & Knight, 2009; Lussier, 2005). Studies consistently find that rapists (more so than child molesters) tend to have persistent and versatile criminal histories and tend not to “specialize” in sexual offending. The empirical reality that sex offenders and non-sex offenders are inherently similar leads to the logical hypothesis that we can also expect them to desist in a similar fashion.

The most well regarded theories of desistance (in addition to “aging out”) emphasize either the pursuit and achievement of informal social controls (i.e. fulfilling employment and a stable relationship) (Sampson & Laub, 1993) or cognitive transformation (Giordano, Cernkovich & Rudolph, 2002) where the individual consciously decides to change their behaviour, begins to see alternatives to a criminal lifestyle, and can rewrite their narrative in such a way that they can leave that life behind, ‘knife off,’ (Maruna, 2001) and become someone new.

Emerging research on sex offender samples (Farmer, Beech & Ward, 2011; Harris, 2014, In Press) so far concludes that, as a population, recidivism rates are fairly low and desistance is the modal outcome, but they appear to be desisting in spite of a range of obstacles that generic offenders do not experience. The realities for a sex offender living in the community post release (especially in the US) severely limit one’s ability to find stable, paid employment and pursue a fulfilling relationship, let alone find safe, affordable accommodation. Furthermore, the debilitating stigma that comes with the label of “sex offender” means that the achievement of a new identity and successful cognitive transformation is especially difficult.

Our mutual objective is the prevention of sexual abuse and the ultimate reintegration of those convicted of such offenses. Our emphasis should therefore be placed on repealing the especially stigmatizing legislation that does little to foster rehabilitation and instead promoting opportunities that encourage identity transformation, the pursuit of informal social controls, and the realisation of good lives.

Danielle Arlanda Harris, PhD

References

Farmer, M., Beech, A., & Ward, T. (2011). Assessing desistance in child molesters: A qualitative analysis. Journal of Interpersonal Violence, 1-21.

Giordano, P., Cernkovich, S., & Rudolph, J. (2002). Gender, Crime, and Desistance: Toward a theory of cognitive transformation, American Journal of Sociology, 107(4), 990-1064.

Harris, D. A. (2014). Desistance from sexual offending: Findings from 21 life history narratives. Journal of Interpersonal Violence. 29(9) 1554-1578. DOI: 10.1177/0886260513511532

Harris, D. A. (in press) Theories of desistance from sexual offending in Ward, T., Polaschek, D., & Beech, A. (Eds.), Theories of sexual offending, 2nd ed., Sussex: John Wiley & Sons.

Harris, D. A., Smallbone, S., Dennison, S., & Knight, R. A. (2009). Offense specialization and versatility in the criminal histories of adult male sexual offenders referred for civil commitment. Journal of Criminal Justice. 37, 37-44.

Laws, R. & Ward, T. (2011). Desistance from sex offending: Alternatives to throwing away the keys. New York: The Guildford Press

Lussier, P. (2005). The criminal activity of sexual offenders in adulthood: Revisiting the specialization debate. Sexual Abuse: A Journal of Research and Treatment 17(3), 269-292.

Maruna, S. (2001). Making good: How ex-convicts reform and rebuild their lives, Washington DC: American Psychological Association.

Sampson, R., & Laub, J. (1993). Crime in the making: Pathways and turning points through life. London: Harvard University Press.


Willis, G., Levenson, J. & Ward, T. (2010). Desistance and attitudes towards sex offenders: facilitation or hindrance? Journal of Family Violence, 25, 545-556.

Monday, March 23, 2015

Desistence from sexual offending


This week I attended a research symposium at Queens University, Belfast, on desistence from sexual offending organised by Shadd Maruna, Anne-Marie McAlinden as well as Mark Farmer. The event was designed to bring desistence researchers, as well as those interested in the topic, together from across the world (including, UK, Ireland, Canada, USA, New Zealand) to discuss present and future research in this area. The conference had interesting papers and informed debates from leading and emerging names in the Field (Shadd Maruna; Gwen Willis; Danielle Harris; Simon Hackett; Patrick Lussier; Anne-Marie McAlinden; Mark Farmer; Kim Kras; Stephanie Kewley; Joanne Hulley; Darren Woodward). The conference covered a lot of different issues including, but not limited to, conversations about research methodology and ethics relating to desistence, community re-entry, resilience, redemption, religion and treatment relating to youth as well as adults; this blog will cover some of the main themes that came out of the conference.

-          Narratives of desistence are similar internationally and cross culturally: Although there are international differences in terms of sex offender policy and practice, there was a great deal of similarity in sex offenders’ narratives of change, redemption and desistence.

 

-          That the use of the label of sex offender is problematic to desistence: One of the strongest themes that emerged from the conference, touted by Gwenda Willis in her presentation, was the impact that the label of “sexual offenders” has upon desistence (recalling Kelly Babchishin’s recent blog and Harris & Socci, 2015). As Willis pointed out, reinforced by other delegates, the use of the label “sex offender” is not only problematic for the individuals in question but also for professionals as well as policy makers in the field as it creates self-fulfilling prophecies. In the conversation which followed there was recognition in the room that we needed to make a conscious decision to stop calling these individuals by the very thing that we don’t want them to be. However, what language can be used instead, when the term sex offender is embedded in public and political discourses?

 

-          Harm Vs offending:  On the second day of the symposium Simon Hackett expanded upon what Gwenda had said about labelling, suggesting that we focus on harm rather than offending. The use of harm is potentially beneficial on a number of levels for working with victims, offenders and across society.

 

-          Youth desistence from sexual offending: Simon Hackett discussed youths who commit sexually harmful behaviour, his findings reminded me of Nicole Pittman’s Raised on the Registry, stating support (formal and informal) was central in allowing this population to desist; consequentially, appropriate interventions are essential.  This led to a debate over the role of social and clinical interventions with individuals who cause harm to others through their sexual behaviour and where the field should be moving for youths as well as adults.

 

-          Researching desistence: When Shadd Maruna opened the research symposium he discussed the issues involved in researching desistence from sexual offending, highlighting that we are dealing with two challenging issues “desistence” and “sex offending”. Among the issues that Shadd highlighted are (1) that desistence is a fluid concept and that all researchers do not necessarily define it in the same way; (2) that sexual offending can be difficult to uncover because of its nature, therefore these two populations are difficult to identify and access; as well as (3) that there are very real ethical and moral issues related to this type of research. The experience of the researchers who talked across the two days reflected these comments; however, interestingly, the researchers commented that once they had secured their participants that all were in the main pleased to talk. The speakers all recalled experience of participants stating that they were happy to be able to discuss their experiences.

 

-          Methodology: The symposium highlighted the range of methodologies being used internationally to research desistence from sexual offending, including qualitative interviews (Harris, Hulley, Kewley, Farmer, Hackett), case studies (Hackett), quantitative methods (Lussier, Hackett) longitudinal research (Lussier, Hackett) and quasi experiments (Lussier). This really highlights the methodological innovations in the field. Although, recognising the sentiment that desistence research in the sexual abuse field is in its early its research is steeped in a rich methodological tradition from across the social sciences.

 

-          Linking together multi-faceted research on this issue: One clear message that came out of the symposium is that desistence is a multidisciplinary issue with speakers and delegates coming from a range of disciplines (Criminology, Law, Forensic Psychology, Clinical Psychology, Sociology). This reinforces the need for research in the social sciences to be grounded is a shared among the social sciences; desistence as well as sexual abuse are multi-faceted social issues and should be researched as such.

This research symposium really reinforced the importance of research into understand why people choose to stop sexually offending; if we can better understand why people choose to stop sexually offending it can better inform interventions, policies and reintegration strategies with this population.

Kieran McCartan, PhD.

References

Harris, A. J., & Socia, K. (2015) What’s in a Name? Evaluating the Effects of the “Sex Offender” Label on Public Opinions and Beliefs. Sexual Abuse: A Journal of Research and Treatment. ifirst http://sax.sagepub.com/content/early/2014/12/24/1079063214564391.abstract

Tuesday, March 10, 2015

The Emerging Use of Feedback-Informed Treatment with People Who Have Sexually Abused



Overview

This blog post explores the use of ongoing structured client feedback in adherence to the responsivity principle of effective correctional treatment. After an introduction to the concept of Feedback-Informed Treatment (FIT), it describes the work of two ATSA members who are using FIT in very different settings.

Background Information

In an important study of what works in group treatment of people who have sexually abused, Beech and Fordham (1997) stressed the importance of attending to therapeutic processes and cohesion in group treatment and found that therapists typically rated themselves as being more helpful and concerned than their clients did. Indeed, client perceptions are more influential in treatment progress than therapists’ beliefs about their own skills (Orlinsky, Grawe, & Park, 1994). Despite what professionals want to believe, we are not the best judges of the therapeutic alliances.

At a time when our field argues whether treatment for people who have sexually abused works, many (e.g., Prescott & Levenson, 2009) have wondered whether our field is actually asking the right questions. Perhaps the most important question is what professionals can do to create programs for clients who may be at risk for refusing treatment or dropping out to “get it” and make meaningful change (Marques,  Wiederanders, Day,  Nelson, & van Ommeren, 2005).

What is clear, however, is that findings of the past decade have cast confrontational approaches into a much less favorable light (Marshall, 2005; Parhar, Wormith, Derkzen, & Beauregard, 2008). In fact, in an influential article regarding addictive behavior, William White and William Miller (2007) stated:

There are now numerous evidence-based alternatives to confrontational counseling, and clinical studies show that more effective substance abuse counselors are those who practice with an empathic, supportive style. It is time to accept that the harsh confrontational practices of the past are generally ineffective, potentially harmful, and professionally inappropriate.

An emerging body of research in the behavioral health field indicates that incorporating formal feedback regarding progress and engagement into treatment services builds responsivity while simultaneously improving outcome and retention (Prescott & Miller, 2014, 2015). Feedback-Informed Treatment (FIT) has been successfully integrated into both mental health and substance abuse services, serving both voluntary and mandated clients, in agencies and systems of care around the world (Bertolino & Miller, 2012).  Multiple randomized clinical trials document that adding FIT to existing treatment services as much as double the effectiveness of the care provided, and reduces attrition and deterioration rates by 50% and 33%, respectively (Miller, Hubble, Chow & Seidel (2013). 

FIT involves administering two scales over the course of treatment; one measuring the quality of the therapeutic relationship (the Session Rating Scale [SRS]), and the other assessing progress or outcome (the Outcome Rating Scale [ORS]).   Over 1,100 studies have made clear the importance of the therapeutic relationship to treatment outcome (Duncan, Miller, Wampold, & Hubble, 2010). Indeed, in an era that emphasizes evidence-based practice, the therapeutic relationship is the most evidence-based concept in psychotherapy research (Bargmann & Miller, 2011). Understanding changes in the relationship can help ensure that clients are meaningfully engaged in change efforts, assist treatment providers in adjusting their strategies to meet each client’s needs (thereby adhering to the responsivity principle), and act as an early warning system for treatment deterioration and failure. At the same time, research has demonstrated that changes in a person’s individual, relational, and social functioning are strong predictors of successful therapeutic work (Bargmann & Miller, 2011; Miller, Duncan, & Hubble, 2004).

As research to date shows, access to real time feedback regarding progress and engagement provides clinicians with an opportunity to adjust services in a way that enhances individual client responsivity and achievement of treatment goals  (e.g., decreased reoffending). The same body of evidence documents that FIT promotes professional development, resulting in measureable improvements in individual provider responsivity and effectiveness (Miller, Hubble, Chow, & Seidel, 2013).  In 2013, FIT was deemed an evidence-based practice by the Substance Abuse and Mental Health Service Administration (SAMHSA) and listed on the National Registry of Evidence Based Practices and Programs.

Of course, evidence-based practices in the field of treating sexual aggression involves adherence to the principles of risk, need, and responsivity. FIT is best thought of as improving adherence to the responsivity principle. As the two vignettes below illustrate, programs adhering to the risk and need principles can further build responsivity by using FIT. The big question is whether the treatment provider and his or her agency is ready for the challenge of listening to their clients’ feedback and open to the professional self-development that follows. Changing one’s practice to meet the needs of clients is not easy. Indeed, maintaining a stance of eager anticipation about what one can learn from their client is vital to collecting the most helpful feedback.

FIT in a Sexual Offender Civil Commitment Setting (Valerie Gonsalves)

At the beginning of each session, I have the patient complete the ORS. If there’s a particular area that rates low, we can direct attention to that area. If there are inconsistencies between unit report and patient report, it can open up the discussion about those areas. For example, if someone received three or four sanctions in a week, but reports that they are doing well overall, raising this discrepancy can provide a nonjudgmental manner of addressing the sanctions. Similarly with the SRS, I administer this instrument at the end of each setting. For patients who may be hesitant to provide feedback or may experience distrust about the nature of the relationship, the SRS can serve as a launching point for conversations about alliance. I typically expand my discussion of alliance to include variables that have been found to be specifically relevant to mandated therapeutic relationships, such as trust, caring and fairness, and toughness (Skeem Louden, Polaschek, & Camp 2007).

Notably, in a civil commitment the mandated nature of the therapeutic relationship can serve as a barrier to accurate reporting. Patients may be frightened of experiencing negative consequences, either legally or within the institution, if they provide the clinician with an honest assessment of their current functioning or suggest an area for therapist improvement. As such, these patients typically demonstrate consistently high ratings on the ORS and the SRS. When this occurs, it can serve as a launching point for a discussing about meaningful treatment engagement or that the therapist may have to engage the patient in a discussion about methods of collecting this information in way that allows the patient to feel safe about being transparent. More often than not, my experience in a civil commitment setting demonstrates that patients will utilize these instruments in a manner that mimics that of community use.

FIT in a Private Practice Setting (Jim Reynolds)

The importance of a positive therapeutic alliance has been consistently described in the literature and is well known by treatment providers.  However, no agency or organization where I have worked has actively measured the therapeutic alliance, much less incorporated aspects of the therapeutic alliance in the treatment planning/delivery processes. Consultation with colleagues suggests that this remains the general state of affairs within our field.

Implementing FIT into a solo, community-based practice is probably much easier than in agencies or large criminal-justice systems.  I did not need to ask anyone's permission.  I simply received training and implemented it without any difficulties.  I was able to easily adjust the policies and procedures which guide the treatment I provide clients, incorporating important principles from FIT into the therapy I provide. For example, my clients are provided complete and unfettered access to their treatment records - within the boundaries of relevant ethical principles and practices. There is no paper work for them to complete. No board or committee needs to be consulted.  A client only has to ask and they can see their case file.

FIT helps me to individualize treatment based on building client capacities and managing risks.  I can structure treatment according to the priorities, goals, preferences, and progress of the individual client as those elements relate to the reason(s) for being in treatment. These goals are not imposed on the client, either by me or by a supervising entity such as probation or parole. Client feedback on the ORS and SRS is taken seriously, and used to monitor/modify the course and length of treatment in real time.

Collaborating with clients and being transparent in my interactions with them helps to create a positive “culture of feedback” in which client input and feedback are integrated into the therapeutic process. The ORS and SRS are valid, reliable, and “user friendly” outcome measures of alliance that I use to guide services throughout the therapy process.  Using the ORS and SRS allows me to objectively monitor and chart each individual client's progress, to determine which clients are making progress and which are at risk for a negative or no change outcome. 

Information from the ORS and SRS helps me identify problems/concerns in the therapeutic relationship that may compromise the effectiveness of treatment. Identifying and repairing problematic alliances can improve clients' motivation for treatment as well as their level of active engagement in therapy.  I am able to use the information from the scales to adjust the level and type of care that I provide each client, in both individual and group therapies, in order to be responsive to each client's perceived needs and treatment goals. 

Overall, integrating FIT into a private practice can be easily accomplished.  Doing so has allowed me to easily collect client outcome data in real time that I can then use to help guide the treatment process. I use that information to guide the focus of therapy, as well as the frequency with which I meet clients. I am able to objectively identify clients who have achieved an optimum level of functioning and appropriately titrate treatment. I can also identify clients who are not benefiting from treatment and, if adjustments to treatment are unsuccessful, make appropriate referrals to another provider.

Conclusion

At first, implementing FIT can be challenging for people working in criminal-justice settings. It involves creating a culture of feedback and being willing to listen to unflattering feedback in order to strengthen the alliance and improve outcomes.  However, those who monitor their alliances and outcomes commonly report improved treatment progress, earlier detection of treatment problems and dropout, reduced client-driven complaints and grievances, and a seemingly endless resource for deep professional development and knowledge.

David S. Prescott, 
Valerie Gonsalves, 
Jim Reynolds,
Scott D. Miller

References

Bertolino, B. & Miller, S.D. (Eds) (2013). The ICCE Feedback Informed Treatment Manuals (6 Volumes). ICCE: Chicago, Illinois.

Duncan, B., Miller, S.D., Wampold, B., & Hubble, M. (2010). The heart and soul of change, second edition: Delivering what works in therapy. Washington, DC: American Psychological Association.

Marques, J.K., Wiederanders, M., Day, D.M., Nelson, C., & van Ommeren, A. (2005). Effects of a relapse prevention program on sexual recidivism: Final results from California’s Sex Offender Treatment and Evaluation Project (SOTEP). Sexual Abuse: A Journal of Research & Treatment, 17, 79-107.

Miller, S.D. & Bargmann, S. (2011). Feedback Informed Treatment (FIT): Improving outcome with male clients on man at a time. In J.A. Ashfield & M. Groth (Eds.), Doing psychotherapy with men. CreateSpace Independent Publishing Platform.

Miller, S.D., & Duncan, B. (2000). The Outcome Rating Scale. Chicago, Illinois: International Center for Clinical Excellence.

Miller, S.D., & Duncan, B. (2004). The Outcome and Session Rating Scales Administration and Scoring Manual. Chicago, Illinois: ISTC Press.

Miller, S.D., Duncan, B., & Hubble, M. (2004). Beyond integration: The triumph of outcome over process in clinical practice. Psychotherapy in Australia, 10, 2-19.

Miller, S.D., Duncan, B.L., Brown, J., Sparks, J., & Claud, D. (2003). The outcome rating scale: A preliminary study of reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2, 91-100.

Miller, S.D., Duncan, B.L., & Johnson, L.J. (2000). The Session Rating Scale. Chicago, Illinois: International Center for Clinical Excellence.

Miller, S.D., Hubble, M.A., Chow, D. & Seidel, J. (2013). The outcome of psychotherapy: Yesterday, today, and Tomorrow. Psychotherapy, 50, 88-97.

Miller, S.D., Hubble, M.A., & Duncan, B. (2007). Supershrinks: Learning from the field’s most effective practitioners. Psychotherapy, 31, 27-35, 56.

Parhar, K.K., Wormith, J. S., Derkzen, D. M., & Beauregard, A. M. (2008). Offender coercion in treatment: A meta-analysis of effectiveness. Criminal Justice and Behavior, 35,1109 – 1135.

Prescott, D.S., & Levenson, J.S. (2009, summer). To treat or not to treat: What are the questions? ATSA Forum, 21, 19-28. Retrieved October 6, 2013
fromhttp://www.davidprescott.net/2009SumrForum_Prescott-Levenson.pdf.

Skeem, J.L., Louden, J., Polaschek, D., & Camp, J. (2007). Assessing relationship quality in mandated community treatment: Blending care with control. Psychological Assessment, 19, 297-410. Doi 10.1037/1040-3590.19.4.397.


White, W. & Miller, W. (2007). The use of confrontation in addiction treatment: History, science and time for change. Counselor, 8(4), 12-30. Retrieved October 6, 2013 from http://www.williamwhitepapers.com/pr/2007ConfrontationinAddictionTreatment.pdf.

Wednesday, March 4, 2015

Q&A with Kristen M. Zgoba, co-author of “The Adam Walsh Act: An Examination of Sex Offender Risk Classification Systems”

Zgoba, K. M., Miner, M., Levenson, J.  Knight, R., Letourneau, E., & Thornton, D. (2015). The Adam Walsh Act: An Examination of Sex Offender Risk Classification Systems. Sexual Abuse: A Journal of Research and Treatment. Ifirst http://sax.sagepub.com/content/early/2015/02/04/1079063215569543.abstract

Abstract

This study was designed to compare the Adam Walsh Act (AWA) classification tiers with actuarial risk assessment instruments and existing state classification schemes in their respective abilities to identify sex offenders at high risk to re-offend. Data from 1,789 adult sex offenders released from prison in four states were collected (Minnesota, New Jersey, Florida, and South Carolina). On average, the sexual recidivism rate was approximately 5% at 5 years and 10% at 10 years. AWA Tier 2 offenders had higher Static-99R scores and higher recidivism rates than Tier 3 offenders, and in Florida, these inverse correlations were statistically significant. Actuarial measures and existing state tier systems, in contrast, did a better job of identifying high-risk offenders and recidivists. As well, we examined the distribution of risk assessment scores within and across tier categories, finding that a majority of sex offenders fall into AWA Tier 3, but more than half score low or moderately low on the Static-99R. The results indicate that the AWA sex offender classification scheme is a poor indicator of relative risk and is likely to result in a system that is less effective in protecting the public than those currently implemented in the states studied.

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

I’d like to say that we had a great story for coming up with the research idea but it was truthfully born out of necessity.  I was in the process of finalizing a National Institute of Justice grant on Megan’s Law and my co-authors and I believed it was necessary and responsible to evaluate the new federal law that became known as the Adam Walsh Act.  The bill was signed into law without an empirical foundation and sought to strengthen many of the stipulations of Megan’s Law.  My co-authors and I were thankful that the National Institute of Justice approved the funding and allowed the empirical research process and findings to speak for themselves. The idea of who would take the lead unfolded in a more comical way with everyone stepping back and claiming they were too busy to be lead!  Having pulled the shortest straw and having the shortest academic career resulted in me becoming the PI.

What kinds of challenges did you face throughout the process?

I think my co-authors would agree that much of the process was a challenge! Our project included five busy researchers, from five different states, with five different IRB approvals and state agency regulations.  I would say the process of data coding and collection probably posed the greatest challenges to my co-authors and I. First, we recognized that in order to code the Static risk assessments, the researchers and the assistants needed to be trained by David Thornton. Since we hailed from five different states (New Jersey, Massachusetts, Minnesota, Florida and South Carolina) we quickly determined that video conferencing was the most fiscally responsible (although a few of us did make our way to warmer climates for group coding!).  This three day training increased the validity of our data coding and our understanding of the instrument.  A second challenge that was particularly burdensome was the unavailability of consistent data collection across the states. Some of the data points were more readily available in some of the states and my co-authors and I had to be creative with our requests for additional data and/or the statistical methods that would take the missing data into consideration.  The states involved with the study were sometimes hindered by an inability to provide information that was beyond their control.  You learn through the process that items that might be intuitive for research purposes, do not necessarily have an operational purpose for state correctional agencies.

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

I quickly learned that I was co-authoring a grant and paper with very busy people!  I think everybody on this grant had experience as a co-author, so we became skilled at establishing schedules and responsibilities upfront.  We used an internet tool to schedule mutually agreeable conference call times and our responsibilities functioned in chronological order.  We then passed each manuscript version on to the next person in line. There were definitely points when we hit periods of natural slowdowns- exams, holidays, summer break, etc. I can’t say we didn’t experience some ‘topic fatigue’, but we understood this would be the case, given the length of our project and our very busy schedules.  I think we also learned that our writing styles varied, as is sometimes the case with larger groups, and our final products needed some verbal ‘smoothing’ and refining.  One difficulty when working with larger groups is having a final product that does not appear as though five people joined together five different papers.

What do you believe to be to be the main things that you have learnt about the impact of sex offenders registration, as well as the related legislation?

The results of our analysis were in line with findings from other studies seeking to determine best practices in the field of sexual offending legislation.  We confirmed that sexual recidivism rates were low, as most of us had reported in our previous research. The sexual recidivism rate was approximately 5% at 5 years and 10% at 10 years.  This of course should lead many to question the ‘one size fits all’ basis of the Adam Walsh Act and many other types of sex offender policies.  Furthermore, we discovered that actuarial measures and existing state tier systems did a better job of identifying high-risk offenders and recidivists than did the AWA. After multiple analyses, the results indicated that the AWA sex offender classification scheme was a poor indicator of relative risk and was likely to result in a system that was less effective in protecting the public than those currently implemented in the states studied.

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

I think the main implication for practice is really that the manner by which states were handling sex offender registration, classification and subsequent notification was working. At least, relative to the current implementation of the AWA, it was working.  Unfortunately, the hands of many practitioners now may be tied to a system that is less reliable than what they were previously using.  This presents a disservice to all involved.


Friday, February 20, 2015

HOW PRECISION IN LANGUAGE CAN HELP PREVENT SEXUAL ABUSE


Primary prevention of sexual abuse involves targeting root problems to prevent the abuse from occurring in the first place. This article will summarize why I believe it is important to discuss the popular but imprecise belief that someone who holds a sexual interest in children is eventually going to commit a sexual offence against a child.


Virtuous Pedophiles is an organization with the goal to reduce the stigma most pedophiles experience by popularizing one fact that most of the public does not know (or at least acknowledge): that a number of pedophiles do not commit a sexual offence. As I discussed in my Nextgenforensic article, most of us overlook the key distinction between the term ‘pedophile’ and ‘sex offender against children’. That is, pedophiles are those who hold a sexual interest in children whereas sex offenders against children are those who have committed a sexual offence against a child (see here for more information on pedophilia). Not all pedophiles are sex offenders and not all sex offenders against children are pedophiles (for an interesting review, see Seto, 2008).


I recently had the opportunity to speak to the co-founders of Virtuous Pedophiles, Nick Devin and Ethan Edwards (pseudonyms). The Virtuous Pedophiles online forum currently has over 600 members and, as noted in their website their “…highest priority is to help pedophiles never abuse children.” Nick and Ethan were kind enough to answer a few questions on the impact of imprecise language and future directions for clinicians, researchers, and policy makers in this field.


ON THE IMPORTANCE OF LANGUAGE

Labels influence peoples’ views and perceptions (for review, see Harris & Socia, 2014 and Janke et al., 2015). Both Nick and Ethan highlighted several reasons for why it continues to be important to be explicit in distinguishing between pedophiles and sex offenders. For example, Nick pointed out the negative impact of the public’s habit of equating pedophiles to sex offenders: “[m]any pedophiles believe themselves to be evil as a result of attractions that they did not choose, even if they don't act on those attractions.  Many are depressed as a result; some are even suicidal”.


Negative public views not only means pedophiles are stigmatized, but also that some pedophiles do not seek help from professionals because of their fear of being discovered. As Nick pointed out, more precise language can change public perceptions and even laws. “I think the source of the hatred is the failure to distinguish between pedophilia and sex offending.  People just are not aware that a great many pedophiles successfully resist their sexual attractions.  If enough people became aware, I think the hatred would be reduced.  Pedophiles would be more willing to get the help they need, and fewer children would be sexually abused.”

 


IMPLICATIONS FOR KEY STAKEHOLDERS


1) Clinicians and Policy Makers

There are a lot of improvements needed to expand services to pedophiles and, ultimately, to aid in the primary prevention of child sexual abuse. I asked both Nick and Ethan what clinicians and policy makers in the field can do to help pedophiles lead more productive lives without offences. Both had important points, which I provide below.


Ethan: “Clinicians can do several things. One is to learn the true mandated reporting requirements in your jurisdiction... Treat pedophiles as people with a difficult life problem, not just as potential molesters. You have been trained for empathy and respect for your clients, and extend that to pedophiles -- especially those who have done nothing wrong. Do not abruptly terminate therapy without providing a referral. Accept that pedophilia is a sexual attraction that was not chosen. Do not try to eliminate the attraction, but help clients work around it and feel OK about themselves as long as they do not harm others. Often pedophiles have no trouble controlling their behavior, but want help with leading a worthwhile life. Knowing that you will never know sex or love, and knowing that everyone would hate you if you told them who you truly are -- these alone are understandable causes of distress.”


Nick: “With respect to policy makers, they need to look at the mandatory reporting rules.  These rules require therapists to report a patient if they think the patient is a danger is to a child.  The rules are well intentioned.  Of course we want to protect children from abuse.  The problem from the pedophile's perspective is that the rules are vague.  No one knows what a particular therapist will consider dangerous, and the consequences of being reported are so severe (e.g., social ostracism) that many people who need help don't go to therapists due to fear of being reported.  Dr. Fred Berlin of Johns Hopkins University use to see a large number of non-offending pedophiles as part of his practice.  He reports that pedophiles stopped coming in for treatment when Maryland adopted mandatory reporting rules.  Dr. Hans Beier runs a program called Prevention Project Dunkelfeld in Germany, which encourages pedophiles to come forward for treatment.  He has said that the program would not be viable in the United States due to mandatory reporting rules.”


As policy makers, it is important to acknowledge the deleterious effects of mandatory reporting law. Overly restrictive laws results in pedophiles not getting the help that may have preventing them from abusing a child. It is true that as clinicians, we are limited by the mandatory reporting laws in our jurisdictions. If you live in a restrictive jurisdiction, which requires you to refer someone who reports a sexual interest in children, it is important to note that there are an increasing number of anonymous online resources available to your client (which I summarize here). Unfortunately, not all clinicians currently do this, as Ethan pointed out:


 “…some researchers have said that most sex offenders commit their first offense when they are desperate and feel they have nothing to lose. Yet when some explicitly seek help, they are told that no resources are available to them unless they have committed an offense.

 

2) Researchers

As a researcher, I was particularly interested in what researchers in the field can do to help primary prevention efforts. Here is a summary of interesting projects that hold important implications, as suggested by Nick and Ethan.

  • Develop a best practices treatment module and disseminate that information to therapists who see pedophiles.

Nick summarized the state of affairs, which highlighted the current uncertainty in our field. Specifically, some researchers/clinicians believe pedophilia can be changed whereas others believe that, like other sexual orientation, pedophilia cannot be changed and, instead, must be managed.


We hear from a lot of pedophiles who see therapists and they report different approaches.  Some therapists say you should try very hard not to fantasize about children.  Others say not to worry about that and focus on strengthening strategies to prevent abuse.  Some try to change a pedophile’s sexual interests to make them attracted to adults.  Others say this isn't possible.  Some therapists are right on this and others are wrong.  Who is right?  What is the best way for the therapist to proceed?

 
A recent article by Müller and colleagues on the subject elicited a number of Letters to the Editor, which highlights the controversial nature of this debate (for those wanting a snapshot of the debate, there is a radio broadcast on the subject). More primary studies are required, and a review article would be useful in providing direction to clinicians.


  • More research on non-offending pedophiles.

Ethan noted “it would be great if there was research on non-offending pedophiles. It is very difficult to study us because we have such a strong motivation to stay hidden. Perhaps anonymous surveys could be formulated with enough protections to convince celibate pedophiles that they really are safe in responding. Representative-sample community surveys could include questions about attraction to children -- why don't they?”


Such studies are certainly doable. Online surveys now allow for anonymous participation. That is, surveys can be created to ensure that no identifying information is collected, such as IP addresses. In addition, b4uact provides help to researchers hoping to recruit self-identified pedophiles. Increasing research on non-offending pedophiles (e.g., the Dunkelfeld group) can improve our understanding of this group of individuals. Census data certainly would be the gold standard, but at least in Canada, we are reducing the scope of census questions (though there is an active debate as to why we should not). Countries with more flexibility in their census survey could provide worthwhile contributions to this field with the simple addition of two questions: (1) Have you ever felt sexually attracted to a child under the age of 12? (2) Have you ever had sexual contact with a child under 12 when you were over the age of 16? The answers to these two questions would provide a robust estimate on how many people with a sexual interest in children actually offend.


  • Summary of mandatory reporting laws.

As Ethan pointed out “Pedophiles assume the worst about mandated reporter laws, wondering if just admitting an attraction to children will get them reported”.
 

A summary of mandatory laws for Canada and states in the USA (as well as other countries) would be a useful tool for any pedophile seeking help, as well as clinicians wondering about the scope of mandatory reporting laws. Access to these summaries may mean that more pedophiles would seek help and, as such, would be a worthwhile project.



CONCLUSION
Ethan offered a simple way forward: “One simple starting point is for every person who hears "pedophile" to ask: Is this a celibate pedophile or an offending pedophile? And if the allegation is towards a pedophile, treat it with the same skepticism you would if the same allegation is made against a non-pedophile.” As university professors, we can teach this to our undergraduates. As researchers, we can make sure to be explicit in our publications. As clinicians, we need to be aware of the distinctions between those living with pedophilia and sex offenders, as well as provide help to the best of our ability given our respective mandatory reporting laws. As policy makers, we can teach this distinction to politicians, as well as highlight the harmful effects of mandatory reporting laws and other policies on prevention efforts.

 
One final thought: we can better prevent sexual abuse if we provide pedophilic individuals with the necessary support and resources. However, it seems that common stumbling blocks (e.g., mandatory reporting law, fear of self-identifying as a pedophile) are due to the popular but imprecise belief that someone who holds a sexual interest in children is eventually going to commit a sex offence against a child. As highlighted by surveys and research studies now available, being a pedophile does not mean you are bound to commit a sexual offence. Indeed, whereas pedophilia likely is not a choice (e.g., studies here and here), committing a sexual offence is a choice, and one that a number of pedophiles do not make. Of course, we can do much more to prevent child sexual abuse, as highlighted by my conversation with the cofounders of Virtuous Pedophiles. One seemingly simple step has to due with being more precise in our use of language.


Kelly Babchishin, Ph.D. is a Banting postdoctoral fellow (CIHR) at the University of Ottawa’s Institute of Mental Health Research and the Karolinska Instutet in Stockholm, Sweden. Kelly’s doctoral dissertation examined change in acute risk factors of sex offenders; her current research involves identifying causal candidates for the onset of sexual offending. Her other research interests include online sexual offending, pedophilia, and risk assessment.

 

Saturday, February 14, 2015

We do not forgive. We do not forget. Expect us.


The above is the partial sign off of the now infamous Anonymous 'hacktivists'. In their early days the group pursued online attacks as a form of non-violent protest, essentially striking back at anyone they perceived to be an enemy of freedom (Poulsen, 2011). These strike backs were usually in the form of distributed denial of service attacks (DDoS) that were designed to disrupt the communications of targeted websites. Whilst the group have been portrayed as an open source brand of radical protesters, their name in recent years has been used in other related ‘causes’, most recently for snuffing out paedophile rings.

The Telegraph, in January 2015 published the headline: "Anonymous hackers turn fire on global paedophile menace" (Telegraph, 2015). However, this is not the first time that this vigilante brand of online activism has turned its attention to indecent images of children. Operation DarkNet was the group’s first campaign against online paedophilia in October 2011.  The group recognised that child sex offenders (CSA) were becoming increasingly Internet savvy and had begun to mask their online identity through ToR. Anonymous used the same technology to shut them down. Additionally, they targeted the web host ‘Freedom Hosting’ accusing it of knowingly hosting indecent images of children. 

In 2011 a discussion ensued as to whether Anonymous were now a force for good, a champion to sanitise our online space. In fact, a poll commissioned by naked security revealed that just over 81% of voters believed Anonymous did the right thing by shutting down websites that hosted indecent images of children (nakedsecurity, 2011). However, the implications of such unsolicited action did not receive support from law enforcement and child protection experts who criticised them for compromising existing investigations by preventing police from gathering the necessary evidence for successful prosecutions and by inadvertently putting more children at risk.

The new mission of 2015, named “Operation DeathEaters” is designed to expose international paedophile networks in the wake of the Westminster child abuse scandal and allegations of institutional cover-ups. Anonymous states the objective of Op DeathEaters is to achieve an independent, internationally linked, victim-led tribunal or inquiry into the trafficking and “paedosadism industry” (Telegraph, 2015). This could in fact garner greater public support than its predecessor because evidence reveals that when Anonymous activists expose the shadowy workings of the state they tend to make the most impact on wider society (Coleman, 2012).

There is no doubt that sexual offending is a devastating crime and one that is currently capturing worldwide media attention, with an almost daily digest of tales of historical child abuse involving celebrities, or institutional abuse that has taken place in a range of settings. Sexual offending behaviour results in a magnitude of complex issues not only for the victim and the offender, but also for wider society as a whole. What media reports like that in the Telegraph don't tell the public is that there is no 'usual' or standard pathway whereby someone will 'become' a sexual offender. We have no idea how many people access child abuse images, but what evidence from convicted offenders does reveal is that they are heterogeneous group (Quayle, 2004).

Child abuse images online and also chat groups/forums may have removed some of the barriers that previously discouraged some people from pursuing their sexual interest in children. However, the function of abuse images and their relationship to contact offending remains unclear.  Therefore, we need to question whether crusades like the one instigated by Anonymous actually do anything to prevent child sexual abuse from occurring in the first place. In debating this issue what we need to be careful of is not to lose sight of the victim in the imagery - the child who has been abused. Essentially, what must be remembered is that the computer is the tool. Sexual offending against children predates the evolution of Internet technology. What we must address is the behaviour, it is by addressing offending behaviour in an evidence based way that children will be protected.

For the general public, child sex abuse is a highly emotive topic with 'knowledge' and misinformation usually emanating from the media. The simplistic undifferentiated approach to sexual offending that is presented is a risky strategy and could in fact dissuade those who want to seek help for their behaviour coming forward to support organisations. Undoubtedly though sexual offending is an issue that the media will continue to pay attention to and, one that society expects will be dealt with. The impact and repercussions of "OpDeathEaters" remains to be seen. What we can be certain of at this stage is that these net vigilantes will not prevent child sex abuse, they will not protect children, nor will this vendetta address offending behaviour. If the ultimate goal is to make society safer and to protect children then it is evidence based practice that must be adopted, rather than vigilantes developing their own crusades which will ultimately be detrimental for the whole community.

Ruth McAlister, Ph.D
University of Ulster, UK

References

Coleman, G. (2012) Beacons of Freedom. Available online at:
(accessed 3/2/15)

Naked Security (2011) Did Anonymous hackers do the right thing? https://nakedsecurity.sophos.com/2011/10/24/lolita-city-and-other-alleged-child-porn-websites-attacked-by-anonymous/ (accessed 31/1/15)

Poulsen, K. (2011) Anonymous  raids, feds work from list of top 1,000 protesters. Avialable online at:

Quayle, E. (2004) The Internet: Potential problems and pathways to hands-on sexual offending, in M. Calder (ed.) Child Sexual Abuse and the Internet: Tackling the New Frontier. Dorset: Russell House Publishing

Telegraph (2015) Anonymous hackers turn fire on global paedophile menace. Available online at: