Friday, February 5, 2016

Sexual Harm in Virtual Worlds

Virtual world and virtual communities are an increasing social phenomenon. To say that they are without law is false, but also it is illogical to believe that virtual worlds are free from criminal acts even through these offences and their perpetrators may differ from offline, as well as other on-line, offending behaviour. Individuals who use the on-line environment to commit or orchestrate sexual harm  can use technology to assist them in committing physical sexual abuse as well as use of the internet to commit non-contact, virtual sexual violence (i.e., through the use of sexually abusive language, imagery, etc). Virtual sexual harm can be multifaceted ranging from inappropriate conversations, the grooming of potential victims for either a contact offence or the production of sexual abuse imagery, or to an on-line, virtual community, sexual offence (i.e., raping a character in game or in a virtual community) (Taylor and Qualye, 2003; Sheldon & Howitt, 2007). Global variations in the development of policies, practices, education, understanding and policing of online sexual harm are pertinent given its growing impact and prevalence (online grooming, online offending, online stalking and trolling). One area where the prevalence, policies, impact and criminal justice responses are still developing is that of sexual harm in virtual worlds.

Since the advent of the internet in 1950’s with the development of computers and the growth and use of technology has challenged the ways and means of communicating with others. Virtual worlds are one such avenue where people communicate on a social educational or business level with others via on-line virtual worlds.  There is no real agreement as to what virtual world means, but Bell (2008) argues that a virtual is a place where real people can enter via a computer and communicate with others. A virtual world is often seen as something that it unreal and which does not reflect the traditional approaches to life, but upon closer examination a virtual world does, more often than not, form close synergies with the real world. In the modern world many social interactions and milestones in peoples lives now take place on-line and in virtual worlds or on social networking sites such as FaceBook, Second Life, World of Warcraft; therefore these social interactions often provide perpetrators the opportunity to meet and gain the trust of a potential victim (Klimmt and Hartmann 2008).

Research shows that most users of virtual worlds are of a young adolescent male who are attracted to the hyper-masculine (macho) arena that can be found within these virtual worlds (Klimmit, 2011). Furthermore these young often males lack the socially honed personal interactions within social spheres with the hyper-masculine attributes they display leading to behaviours that would not normally be tried out in the real world being carried out in the virtual worlds (Klimmt 2011); therefore boundary testing free from social consequences. This reinforces the experimental, boundary pushing aspects of risk taking behaviour often found in youths as a consequence of their development rather than an indication of an ongoing, life course persistent pattern of offending behaviour. Therefore begging the question; are virtual worlds and live action gaming testing grounds for future offline offending or merely an exploratory arena for risk taking behaviour?

Individuals acting within virtual worlds can see their actions as being quasi-real and therefore believe that said actions do not fully adhere to the moral and ethical norms learnt, as well as reinforced, through normal social behaviour in the real world. Deviant behaviour (sexual and non-sexual) can often be justified and perceived as acceptable in this instance with perpetrators using cognitive distortions to justify their deviant behaviours arguing that “it’s not real”, “that people on these sites should know better and not take comments at face value” and “there are no real victims”. However, when these online offences (especially virtual offences in online environments against avatars or via comment boards) take place they are   consciously acknowledged by the victim who feels and believes that they are a real crime (Klimmt 2011). Although, there may not always be  a fear of physical violence in these cases the victim may have be psychologically traumatised by the event which could have result in a negative psychological reaction (anxiety, fear, distrust) and adverse behavioural response (isolation, withdrawal or aggression). Hence, the virtual world/on-line offence could affect their offline behaviour, especially if they believe their on-line and offline lives are firmly tied together and co-dependent.

As we known responding to sexual offending, in general, is a difficult line for the government and the Criminal Justice System agencies to tread, but this difficulty increase exponentially in respect to on -line sexual harm with a multitude of countries, corporations, laws and red tape involved. This begs the question of, how virtual worlds are regulated both inside and outside the virtual world.  General guidance and criteria relating to what constitutes a virtual world crime should be considered in the first instance before any legislation or regulation is handed down to regulate virtual words. Having said this, although regulating virtual world and communities is a difficult and complex task does not mean that the virtual world should be a place where criminal acts are condoned or go unpunished (especially those related to sexual harm), rather the laws must be considered in terms of the best fit for the environment in which it finds itself in.

Kieran McCartan,PhD, & Clare Jones, PhD (Associate Professor in Law - UWE, Bristol)


Bell, M. W. (2008). Towards a definition of virtual worlds. Journal of Virtual World Research, 1:1.

Klimmt, C., & Hartmann, T. (2011). Mediated interpersonal communication in multiplayer video games: implications for entertainment and relationship management. In Konijn, E. Tanis, M. Utz, S. Barns, S. (eds) Mediated interpersonal communication. Routledge, New York, pp.309-330.

Klimmt, C. (2011). Virtual Worlds as a regulatory challenge, a user perspective. In Cornelius, K., & Hermann, D. (eds) Virtual Worlds and Criminality. Springer. Pp. 1-19.
Sheldon, K., & Howitt, D. (2007). Sex Offenders & the internet. Chichester: John Wiley & Sons, Ltd.

Taylor, M., and Quayle, E. (2003). Child Pornography; an Internet Crime. Hove and New York; Brunner-Routledge.

Friday, January 29, 2016

Talking prevention with Charles Flinton - What it can mean when one ATSA member invest in prevention.

As co-chair of ATSA’s prevention committee, I am often asked by members, “What can I do to get involved in prevention?”  Charles (Chuck) Flinton has one unique answer for taking the knowledge and research in our field and applying that to a unique approach to preventing sexual abuse.   Chuck has invested significant time and some funding to develop the Blue Rock Institute (, a resource for adults to access if they are concerned about their own fantasies or behaviors and want help before anyone is harmed.  Take a minute to look at this interesting website and this warm and positive approach to encouraging people to ask for help. 

The Blue Rock Institute is designed for people who know they have a problem and want help.  When someone does call and come in, the Institute begins with a comprehensive evaluation that involves a clinical interview and psychological testing, looking specifically for other co-occurring issues (e.g., food disorder and other compulsive behaviors).  A key portion of this evaluation is to also identify the strengths they bring to the table to help them move away from their shame.  At this point, the Institute may also prescribe medication as well as Individual and group treatment.

When I asked him how he started on this path, he said that “Over the years, I came across so many people who essentially lost everything in their lives due to their offense.  These were guys who knew they had a problem and many even were seeking help but were rejected – that is the truly sad part.” 

After conducting a number of focus groups, hiring consultants and developing the online resources, the program was ready to launch.  He found that people talked about their fear of “crossing the line” and a major motivator is possible financial ruin.  But getting the right message was only the first part of the challenge.  The next challenge is to encourage people to call and then walk in the door.  Much of that has happened organically with people telling others about the Blue Rock Institute.  For example, one client goes to SAA meetings and announces there that there is a new resource and how helpful it can be.  However, Chuck has also made a conscious effort to talk with everyone and anyone about this work.  He has presented at a variety of conferences and also regularly presents information to health centers and other medical venues.  In the spirit of talking with everyone, it was a connection at the gym that brought the program to Kaiser Permante, the largest health care provider in CA.  Chuck was working out and started talking with a workout buddy about his new project.  The workout buddy was also the chief psychologist for the entire state and invited Chuck to present to his staff.  From there Chuck was able to build an ongoing relationship with this provider for when people do come forward, they can get help. 

Chuck’s one piece of advice is to talk with anyone and everyone.  I asked him how he talks about it so that people will really listen.  He tries to engage people in the idea that this affects so many people they know and no one seems to talk about it.  Chuck moves them from “rubber-necking” and “gawking” at the problem to really talking and thinking about this issue.  And he does talk with everyone, presenting at conferences across the country, anyone interested in sexuality, addictions, and of course, a few ATSA chapters too.  If you want to read more, you can see information about his work in the most recent issue of Psychology Today. 

This is just one example of what one ATSA member is doing.  Think about what you might want to do to get involved in preventing sexual abuse before anyone is harmed. 

Joan Tabachnick



Friday, January 22, 2016

Discussing CoSA research & Evaluation with Martin Clarke & Mechtild Hoing, PhD

This author Q & A is a bit different as we have two separate authors (Clarke & Hoing) discussing two separate papers on CoSA in forthcoming editions on SAJRT.

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

When the Dutch CoSA project started in 2009, one of the first concerns of the project developers was: “Is it safe to employ volunteers in this work with sex offenders?” The Dutch CoSA project was driven by the Dutch Probation organization, and although originally this organization was founded in the end of 19th century as a charity, completely driven by volunteer laymen and –women, the organization had become a completely professional institution, during the 20th century. Employing volunteers had become an exception, and the expertise regarding volunteer recruitment, retention, support and supervision had to be built again at the start of the CoSA project. At the same time, in the Netherlands – as elsewhere- sex offenders were in the center of public attention – and vigilance, for that matter. While the CoSA pioneers from the Dutch Probation organization were very enthusiastic and almost passionate about this new, practice based approach, my co-authors and I (who had been involved in the Dutch CoSA project from the very beginning) realized that CoSA needed a broader basis of scientific evaluation, in order to support the project development and to inform project policy decisions, as well as to be able to answer to legitimate questions of professionals in the field. I was given the opportunity to do a PhD study on CoSA, and it was clear from the beginning that one of my research projects would focus on the impact of this work on volunteers. An extensive review of the literature on the impact of volunteering in general and of working with sex offenders, had given us a good idea of the main concepts that needed to be studied.

It was partly out of neccessity in preparation for a funding application. We wanted to produce an up to date review of the evidence for Circles. We focused on quantitative studies because we wanted to try to quantify the findings. That said, there is also a growing body of qualitative research in support of Circles – perhaps another paper is needed!

What kinds of challenges did you face throughout the process?

 Mechtild: Originally, this study was set up as a prospective study, with three measurements (pre-circle, after six months and after twelve months), and a comparison group of volunteers, doing other high impact work (a telephone help-line for suicidal people). However, recruitment of a sample that would be substantial enough for meaningful statistical analysis soon proved to be impossible, mainly because of the small scale of the CoSA project at the time. Also, recruiting volunteers from other volunteer projects was very time-consuming. Therefore we had to look for a more pragmatic solution. We decided to postpone the study for another year, expecting numbers of active volunteers would have risen by then. To make up for the time lost, we decided on a cross-sectional design, only targeting CoSA volunteers.  After one year, the population of Dutch CoSA volunteers had almost doubled, but was still small (little more than 100 active volunteers), and although the CoSA project organization very much supported this study by facilitating the recruitment of volunteers, response rates were low. The volunteers proved to be highly motivated to work with sex offenders, which not necessarily meant they were motivated to fill in a lengthy questionnaire about their work. Although a 37% response rate in a web-based questionnaire is not unusual, we had hoped for more.

 Martin: One of the main things was to put in context the research and the methodological limitations of the studies. Circles were a spontaneous response to improve reintegration back to community and research wasn’t at the forefront. There’s also flexibility in providing Circles and so there are differences  between (and within) Circles Projects even within the same country. Some of the outcomes were not reported in a way that made them comparable to other studies but authors willingly provided additional information which helped.

The reviewers’ comments were also helpful in shaping the paper. Initially we had intended to include a meta-analysis of recidivism data but there was only one RCT and three case control studies. We would have needed to include several caveats when reporting the meta-analysis. Even then, there was a risk of going beyond the data so we didn’t include one.

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

Mechtild: Since my co-authors were also my supervisors, it was clear from the beginning, that I was going to take the lead in all steps of the study, and they had an advisory role. Fortunately, all three of us had the same ideas about the changes in the research design, and that decision was made in mutual consent, once the problems emerged. The analyses of the results of the cross-sectional study were more heavily debated, since I was anxious to make most of the data, while my supervisors urged me to be less ambitious. Of course, they were right, and our discussions helped me to improve my statistical knowledge. Writing in English was a challenge for all three of us, and publishing in English without a native speaker in de group is one thing I would probably reconsider.

 Martin: The process worked well. I’ve usually written with more co-authors. In a way, I think it’s a little easier with fewer co-authors in that you’re not waiting for more people to respond. Birgit and Sue (my co-authors) are very knowledgable about Circles and Circles research.

What do you believe to be to be the main things that you have learnt about Cosa and its application in sex offender integration?

Mechtild: CoSA seems to be a rather robust model. One of the main results of our study was, that not only sex offenders profit from CoSA, but volunteers seem to do so as well. The strength of the model is its focus on building relationships of trust, openness and accountability, not only between the sex offender and the volunteers, but also among  the volunteers themselves and between volunteers and the professional staff. The social support both from co-volunteers and from the circle-coordinator increase feelings of connectedness and competence, thereby adding to the well-being of volunteers. The current policies in Dutch CoSA projects regarding selection, training and supervision of volunteers seem to work. One must keep in mind though, that the role and quality of the circle –coordinator is a critical element in the model, one that needs further evaluation.

Martin: The evidence is supportive of Circles and there has also been nothing to suggest that Circles have an adverse effect on outcomes. We know social exclusion and isolation are risk factors to reoffending and so intuitively it makes sense to provide support to such offenders. That said, there is clearly more that can be done to strengthen the evidence base. We still need larger samples with control groups and longer term follow-ups given what we know about the low and slow rates of reconviction for sexual offences. We also need agreement on which short term outcomes would be useful.

We need more evidence on the accountability aspect of Circles. Clearly Circles offer an extra layer of surveillance which could lead to detecting recidivism which might otherwise not have been detected. So I think the role a Circle had in outcomes needs to be better documented, whether this is a positive outcome such as finding employment or a less successful outcome such as recidivism. Even then, outcomes such as being recalled to prison are not necessarily negative if that prevented further victims.


Friday, January 15, 2016

Reflecting back, moving forward: Part 2 – Looking forward to 2016

Welcome to part 2 of our New Year’s blog! In this part we will address what we think are some of the salient issues facing the sexual harm field as we move into 2016.

Kieran McCartan: The thing that really strikes me, and it’s something that I have written about on the blog quite a bit in 2015, is the continued need for cross disciplinary collaboration and looking outside of our silo. This is really starting to happen now, which is great but we need to do more. Looking to other areas of psychology, criminology, social policy, public health, biology and neuro-science [to cite a few disciplines that we have seen the field of sexual harm successfully utilize] has lead us to some really interesting places including conversations about prevention, desistence, trauma informed care, and mindfulness; all of which have really helped our field look at the population that we work with in a different way. What’s next? What is the next area of social, human and biological sciences going to bring to the table? In addition to looking at other research and theories we should also consider what different disciplines can offer us in terms of new methodologies, new forms of data analysis and new places to present our data [in terms of conferences, journals and forums – maybe we go to a specialist conference and present our work rather than inviting the most amenable to ours]. By embracing the fact that sexual harm is a topic that can unite us all together as a common topic of endeavor, rather than isolate us out as a specialist field, we can make great leaps forward.

As a research field we have started to move further away from the mainstream of sexual harm perpetrator to look at female offenders, offenders with learning difficulties, minority groups and sexual harm and so on. This is great, we are no longer playing the game of “erase male, white sex offender and replace with xxxx”, we are really getting into the nuts and bolts of the array of groups that commit sexual harm and seeing what is unique about them that is different to the mainstream [as well as recognizing what is the same] which will help us design treatment programs, risk assessment, management strategies and prevention plans that are fit for purpose. This is “what works” in action!!

I suppose that my main point in all of this is “look outside the defined sexual harm box”, look to other places for inspiration, for knowledge and to see if what we already know works with everybody that we engage with; as I said before we already do this but we can do it much more and reap greater rewards because of it.

David Prescott: In a powerful speech at the Evolution of Psychotherapy conference in 2009, Phil Zimbardo (principle actor in the infamous Stanford Prison Experiment and later President of the American Psychological Association) offered a definition of evil: “When you know better and you still do worse.”

The past 30 years have seen an explosion of science-based knowledge in our field. From Freund’s pioneering research using phallometrics to the certificate-of-confidentiality research of Gene Abel and his colleagues that did much to reveal what people do and don’t get caught for, to the remarkable Hanson and Bussiere meta-analysis of 1998 and the others it spawned and the exploration of therapeutic and protective factors offered by Bill and Liam Marshall, Calvin Langton, James Worling, and others too numerous to mention.

During 2015, our field saw three sex offender civil commitment programs declared unconstitutional, two by federal judges. Perhaps just as importantly, we also saw several world-class programs (at least two in Canada and at least one in the USA) shut down or restructured and handed over in lowest-bid situations. In some cases, programs have opted to use highly scripted curricula instead of ensuring the effectiveness of each clinician. On one hand, professionals needn’t be surprised; cost-cutting measures in the human services are by now familiar. On the other hand, one wonders to what extent therapists are now finding themselves colonized by curriculum developers from well outside the circumstances in which they work. Research consistently highlights the same factors that define evidence-based practice: clinical experience in combination with the best available research and client characteristics. In light of these events, can we really say that our field was better off in 2015 than it was in 2005?

Surprisingly, these recent events have garnered little discussion within ATSA’s membership. Recent listserv discussion has centered more on what goes well within these programs than their shortcomings, with only one suggestion for policy that might be more effective (and even in that case, the author of the post expressed concerned that such policy could also be misused for political ends). One comment dismissed a recent finding of unconstitutionality as resulting from just “a low level federal judge.” One wonders at what point we should all become outraged by the public-safety and human rights implications of our circumstances. How much energy should we spend defending the status quo? Or should we take more of a stand? Questions abound: how do individuals and organizations best put their money where their mouth is? Given that so few policymakers are swayed by actual evidence, how do we influence decision-makers?

The above are questions our field has asked for a long time. Perhaps it’s time for new questions: At what point do we stop accepting the status quo? At what point do we start to wonder whether we’ve lowered our standards of care? At what point do we start advocating for the rights of all people in the equation, including our clients? And at what point do we look in the mirror and ask whether we are doing worse even as we know better?

Jon Brandt: The dark era of “nothing works” with sex offenders introduced a false doctrine that today is still influencing public policy around the treatment and management of sexual offenders (Mancini & Budd, 2015). 

It is now more than four years since the US District Court for Minnesota agreed to consider the constitutionality of sexual offender civil commitment (SOCC) in Minnesota.  Last June, Federal Judge Donovan Frank determined that both the program and underlying statutes are unconstitutional.  Almost simultaneously, another federal court found Missouri’s SOCC program unconstitutional.  In 2015 a Texas state court judge released the first client from Texas’ SVP program, citing unconstitutional confinement.  A Texas appeals court reversed the ruling and the client was returned to custody.

These court rulings did not say that these SVP programs are not providing credible treatment, but rather that the programs, which have almost no releases, are constitutionally compromised.  Over the last year, David Prescott and I wrote a series of blogs on the MSOP lawsuit.  My personal position is not that SVP programs shouldn’t exist, but rather that, in many states, SOCC is overreaching and/or compromised by the failure to effectively move clients through the system. 

On 10/28/15 Judge Frank issued an order for constitutional remedies in Minnesota.  On 12/15/15, the US Court of Appeals stayed Judge Frank’s order.  The Eighth Circuit agreed to hear oral arguments in St. Louis on 4/12/16.  What seems shortsighted about the Appeals Court ruling is that the crux of Judge Frank’s remedies order is that MSOP must begin evaluations to determine which clients meet criteria for SOCC.  Whether or not the rulings of the US District Court of Minnesota are upheld by the Eighth Circuit, there are hundreds of clients at MSOP who must be evaluated, and even under Judge Frank’s timeline, some might not be evaluated until 2018. 

Parties to the Minnesota lawsuit largely agree on one point: there are clients at MSOP who deserve a reduction in custody or a less restrictive alternative.  If that is the case, such clients are being unconstitutionally incarcerated.  Some clients have been at MSOP for more than 20 years, some are intellectually disabled, more than 60 are juvenile-only offenders, and some are elderly and infirmed.  The oldest is 93.  For over 700 clients at MSOP, the New Year marks another year that the exits are blocked and clients are caught in an endless loop of treatment.  If Minnesota is unable or unwilling to comply with a judicial order to evaluate, and annually reevaluate all 700+ MSOP clients, it would seem that Minnesota’s SOCC scheme is still on a collision course with the US Constitution, and perhaps a review by SCOTUS.

In 2008, Eric Janus and Robert Prentky wrote a twenty-year retrospective on the use of SOCC in the US, arguing that civil controls of sexual offenders, including sexual offender civil commitment (SOCC), are misguided and more about moral panic than sound public policies for public safety.  Perhaps we should acknowledge what Judge Frank has referred to as “society’s opprobrium” for sexual offenders – and that, in many cases, unwarranted civil regulations are impeding, rather than facilitating recovery of those who have sexually offended.   Do such public policies make society safer?

In Part 1 of this blog, I gave a shout-out to Elizabeth Mustaine and her colleagues for their 2015 journal article on how professionals might be contributing to misguided polices of civil regulations of sexual offenders, including residency restrictions, community notification, and the sex offender registry.  When residency restrictions amount to banishment, there are thousands of juveniles on the sex offender registry, and research concludes that the vast majority of sexual offenders (even SVP’s) will not reoffend, it is time to challenge public policies that are not only unwarranted, but largely counterproductive, if not outright unconstitutional.  Aside from civil rights violations and collateral consequences, one of the many unfortunate side effects of misguided public policies is that they fuel unwarranted public fear.

When the ethical concerns of working with those who have sexually offended are so difficult to reconcile with laws, court rulings, victim rights, public safety, and public opinion (which at times can be at odds with each other), it seems more important than ever that professionals who work in the field of the treatment and prevention of sexual harm are current on research and guided by best practices.

Kieran McCartan, PhD; David Prescott, LISCW; Jon Brandt, LICSW

Tuesday, January 12, 2016

Reflecting back, moving forward: Part 1 – Highlights 2015

Welcome back to the SAJRT blog and happy new year! 

The first blog of the year is going to be in two parts, one looking back at 2015 and the other looking forward to 2016. We are going to select what we consider to be some of the standout articles from the 2015 across the sexual harm field.

David Prescott - SAJRT’s February 2015 special edition on protective factors propelled our field forward in a vital direction. It captured the imagination of our organization as a whole and inspired important discussion at conferences and on ATSA’s listserv. All too often in this author’s experience, professionals acknowledge the importance of such ideas as resilience and desistence without being able to put these concepts meaningfully into practice.

Of note, many ATSA members, like the contributors to the special issue themselves, have noted that there has long been no secret of the importance of this avenue for inquiry and understanding. This was the first collection of articles in our field on the topic. Adding even greater appeal is that the guest editors are experts in assessing and treating adults and juveniles respectively (Calvin Langton and James Worling).

The issue begins with an excellent overview from Langton and Worling (Introduction to the Special Issue on Factors Positively Associated With Desistance for Adolescents and Adults Who Have Sexually Offended), in which they offer defining features of protective factors (e.g., those attributes that enhance competencies, ameliorate specific risks, stabilize or enhance functioning, and are associated with desistence). Langton and Worling also discuss two domains of protective factors. The first involves factors that are at the other end of a continuum with a corresponding risk factor (e.g., early versus late adulthood, social isolation versus interpersonal competence). The other domain involves factors for which there is only a positive association with desistance (the authors offer the example of religiousness).

In the end, the idea of protective factors is not new, but this collection of studies provides an important way forward for those concerned with assessment, treatment, and prevention.

Kieran McCartan –  One of my stand out articles comes from the same edition of the journal as David’s, the February special edition on protective factors [which was a sterling edition across the board], with the article by de Vries Robbé, Mann,  Maruna, and Thornton on Protective Factors Supporting Desistance From Sexual Offending. This article talks about the need to reconsider risk, risk management and treatment, emphasizing that we need to be proactive. As the article states, in general, risk assessment focuses on the issues that the offender poses to themselves and to the public, so that their behavior can be limited and controlled; therefore, the core of risk assessment is preventing future harm, which is not necessarily the same as changing the personal insights of people who have committed sexual harm. Placing a conversation about proactive factors within the context of desistence from sexual harm is important as it emphasizes the role of the individual, the capacity for the individual to adapt and grow. This article reinforces a greater move going on in the sexual harm field to change the narrative from a reactionary one to a proactive one (i.e., public health models, prevention, desistence) recognizing that the individual who has committed sexual harm to be proactive in changing their behavior, they are active agents in their own change not passive recipients directed by others (.e., police, probation, treatment providers and the wider community). What makes this article more powerful in its discussion pf proactive factors and there role in desistence is the creditability and power of the authors, leading researchers in the field giving important insights to help us prevent as well as responding to sexual harm

Jon Brandt - My pick for a noteworthy journal article of 2015 is Criminal Justice Officials’ Views of Sex Offenders, Sex Offender Registration, Community Notification, and Residency Restrictions by Mustaine, Tewksbury, Connor, andPayne.

Mustaine and colleagues reviewed existing literature, and conducted their own survey of more than 1,100 public officials across five domains: community corrections, prosecution, law enforcement, parole boards, and prison wardens, to measure attitudes about sexual offenders and beliefs about both the fairness and the efficacy of certain civil regulations for sexual offenders.  Using the CATSO (Community Attitudes Toward Sex Offenders) Scale, and a 43-item survey, the authors compiled a multivariate analysis of various domains, including the number of years of professional experience, amount of education, age, gender, race, marital status, political views, and geographic regions.  Then the authors delved into respondents’ beliefs about both the fairness and efficacy of SORN and residency restrictions.

Among noteworthy findings is an inverse correlation between how closely professionals work with sexual offenders and whether they tend to support civil regulations.  Prosecutors and police are perhaps influenced by their unique responsibilities for public safety and contact with victims. “Law enforcement officers held more negative views of sex offenders than the general public and were less likely to believe in the possibility of their rehabilitation… 83% reported that they would still support at least some SORN policies, even without scientific evidence to support the efficacy.”  “The negative and cynical views that law enforcement officers and prosecutors have about sex offenders appear to transfer over to sex offender policies.” As education and experience increased, the more that professionals questioned both the fairness and efficacy of SORN and residency restrictions.  The more contact that professionals had with sexual offenders, the more positive and optimistic were their views.  Probation agents and psychologists held the most positive and optimistic collection of views.

This research is vital to understanding how public policies are influenced by those who work with sexual offenders; “Criminal justice officials’ perspectives regarding sex offenders and sex offender policies may be especially valuable to policy makers and the public because of their direct experience with both.”  The authors also note that, “it is the sum of actions by officials across the criminal justice system that influences the criminal justice experience for sex offenders (and perhaps their rehabilitation).”    Knowing how criminal justice professionals view sexual offenders and understand the efficacy of SORN laws will help us to target education and shape more effective public policies in the future. “Education aimed at criminal justice officials that debunks misconceptions and affirms the value of rehabilitated sex offenders should not be underestimated.”

The next blog post will continue this discussion focusing on what we think some of the main issues facing the field of sexual harm will be in 2016.

Kieran McCartan, PhD; David Prescott, LISCW; & Jon Brandt, MSW, LICSW


Langton, C. M., & Worling, J. R. (2015). Introduction to the Special Issue on Factors Positively Associated With Desistance for Adolescents and Adults Who Have Sexually Offended. Sexual Abuse: A Journal of Research and Treatment, 27: 3-15.

de Vries Robbé, M., Mann, R. E.,  Maruna, S.,  and Thornton, D. (2015]. An Exploration of Protective Factors Supporting Desistance From Sexual Offending. Sex Abuse: A Journal of Research and Treatment, 27: 16-33.

Mustaine, E. E., Tewksbury, R., Connor, D. P., & Payne, B. K. (2015). Criminal Justice Officials Views of Sex Offenders, Sex Offender Registration, Community Notification, and Residency Restrictions. Justice System Journal, 36:1, 63-85.  (Note: this link is to the full article.)

Wednesday, December 16, 2015

Talking about individuals with learning difficulties who commit sexual harm in 500 words or less

Most programs for people who have sexually abused say they follow Risk, Need, and Responsivity. This is a good thing, but do they really do that? We know that some programs ignore risk, while others don’t really focus on specific client needs. In my opinion, however, the biggest problem with RNR is that we still don’t know what to make of responsivity.

I work with a lot of clients with intellectual disabilities or other cognitive problems. I try to make sure that clients get assessed, treated, and managed in a way that fits their special needs, but what do I mean by special needs? Is it just low IQ or some kind of brain injury, or do we need to think about other problems? What about fetal alcohol effects? What about mental illness? Also, what about clients who were in prison for a very long time who can’t think so well anymore because prison didn’t give them much practice? This definition may be a bit broad, but the point I really want to make is that clients with special needs require special treatment – with specialized tools and procedures. Sometimes, this means we have to be creative.

Now that we know who the special needs people are, how we help them with their problems? A real problem with many programs is that they don’t have books or exercises that were made for special needs clients. Can we use those programs as they were originally written? Do we just talk slower? Do we make the program longer and give it in smaller bits? Research and experience tell us that slower and longer may help some clients, but no special changes at all doesn’t really work. Slower and longer may also lead to problems. My good friend tells a story of his early career when he was trying to explain something to an intellectually disabled client – slower and longer. After getting frustrated, the client said, “Man, I’m retarded. I’m not stupid!” Easier language, with more pictures, repetition, and social stories helps. We also need to remember that nobody likes to have their nose rubbed in their problems, so respect is also really important. What we work on may end up being pretty much the same, but we need to remember that special needs requires special attention.

Managing risk also requires a different approach. Sadly, many special needs clients will never enjoy the same quality of life as their friends without difficulties. A lot of staff are now focused on the idea that special needs clients have the same rights as people without disabilities or cognitive problems. I’m not totally sure about this. I agree that all special needs clients should be able to live as normal a life as possible, but I think we need to be realistic. Do our special needs clients also have the right to good service? What if getting good service means that some clients won’t get to do what they want to? Is that fair? I understand the need to ensure equal opportunity, but being kind and caring enough not to let clients fail is also important. Bill Marshall says Warm, Empathic, Rewarding, and Directive – I agree.

So, that’s 529 words…but they’re 529 words with an average character length of 4.5 and an overall Grade level of 7.2. Still too high for most of our special needs clients, but keep in mind, I’m a psychologist.

Robin J. Wilson, Ph.D., ABPP
Sarasota, FL

Thursday, December 10, 2015

The “Who Works” Doctrine

In 1974, Robert Martinson published a now-classic text concluding that he was unable to find evidence of the effectiveness of rehabilitative efforts for people involved in the criminal-justice system. Although a section of his essay was titled, “Does nothing work?” it became known as the “nothing works” doctrine. Despite the fact that Martinson himself essentially admitted he had been wrong (Martinson, 1979), the nothing works doctrine held sway for many years until Canadian criminologists such as Paul Gendreau introduced the “something works” doctrine (meaning that it was clear that rehabilitative efforts could work, even if the exact mechanisms remained unclear), and eventually the “what works” doctrine that followed (e.g., Gendreau & Ross, 1987).
What works in treatment seems clear enough, but is it really? The principles of effective correctional rehabilitation (i.e. risk, need, and responsivity) state that we should provide more intensive treatments to those who pose the highest risk, focus on empirically supported treatment goals, and use empirically supported techniques (e.g., CBT).  The responsivity principle further states that we should match treatment to the individual characteristics of each client (e.g., cognitive ability, culture, mental health needs, motivation).
From such simple principles many controversies can emerge and great minds can disagree.   For example, one client who has sexually offended against children might benefit from treatment addressing interpersonal skills in such a way that sex with children is unnecessary and undesirable because of the client’s ability to form intimate relationships with adults. Another client might reap minimal benefits from such treatment, because it is the combination of sexual interest in children and a suite of beliefs supporting abuse that contributes more to his risk. As Tony Ward recently pointed out (Yates, Prescott, & Ward, 2010), absent an explanatory means for understanding risk factors, they may simply be markers for further investigation and understanding in programs that seek to reduce risk and build capacities.
There is no question that the principles of risk, need, and responsivity are vital contributors to “what works” in treatment. However, a robust research literature both inside and outside our field points to the fact that who the professional is can be a vital contributor to building responsivity and beyond. As a result, we are proposing a “who works doctrine” alongside the what works doctrine. The name is intended to be provocative and only slightly tongue-in-cheek, and intended as a homage to those brilliant researchers who came before us. To illustrate the importance of thinking in terms of “who works” in addition to what works, it may be helpful to review influential developments of the past.
In 1979, Edward Bordin proposed a model of the therapeutic alliance that involved agreement on the nature of the therapeutic relationship, and agreement on the goals and tasks of treatment. Subsequent research by Jon Norcross and others would also highlight the importance of having therapy take place in the context of strong client preferences (Norcross, 2011). These four areas: agreement on the nature of the relationship, goals, tasks, and values form the basis of a critical element of treatment. Over a thousand studies have pointed to the contribution of the alliance to successful therapy outcomes. Recent research has highlighted the importance of clinicians getting feedback from their clients in these areas (e.g., Lambert, 2010; Prescott & Miller, 2015). In fact, one can argue that attention to the alliance is amongst the most evidence-based therapeutic activities there is. Without it, targeting criminogenic needs is useless, and a greater waste of resources for those at highest risk (since they presumably receive the most treatment).
Likewise, Bill Marshall’s classic 2005 summary of research that he conducted with others points to the qualities of the most effective professionals (Marshall, 2005). They are warm, empathic, rewarding, and directive (in the sense of being able to guide people and processes. However, much of our field remains influenced by early texts and professionals who advocated a more overtly confrontational approach (e.g., Salter, 1988). Indeed, a 2008 meta-analysis by Karen Parhar and her colleagues found that the more coercive the treatment experience, the less likely it is to be effective (Parhar, Wormith, Derzken, & Beauregard, 2008). Most recently, Theresa Gannon and Tony Ward published an important paper titled, “Where has all the psychology gone?” that illustrated how far correctional programs can stray from what – and who – works in helping people in the legal system to rebuild their lives (Gannon & Ward, 2014).
Elsewhere in the psychotherapy literature, there is evidence that there is a greater difference in success between therapists practicing within a model than there is between models themselves (Wampold & Imel, 2015). Likewise, there is considerable evidence that the most effective practitioners in any endeavor tend to spend more time engaging in activities meant to improve their skills and outcomes (Ericsson, XXX). It is important to separate deliberate practice aimed at improvement from simply practicing a lot. More hours doing the same thing can be just that – doing more of the same. This is particularly crucial when one considers research finding that therapists often overestimate their effectiveness (e.g., Beech & Fordham, 1997; Walfish, McAlister, O’Donnell, & Lambert, 2012).
However, in some quarters, our field is paying less attention to therapeutic variables and focusing on cutting costs by engaging in a very high level of manualization at the expense of a deeper and more meaningful treatment experience (Albright, 2015). There is no reason to believe this will work. For example, Janice Marques and her colleagues found in a randomized clinical trial that there was no difference in re-offense rates between those who did and didn’t complete abuse-specific treatment, although those who “got it” and meaningfully completed their treatment goals really did re-offend at lower rates, although these individuals received no further study. It is therefore not difficult to see how over-manualization (e.g., highly scripted rather than individualized) can easily result in problems adhering to the responsivity principle.
What works in treatment? We propose it is time for a return to a greater attention to factors related to specific responsivity and to draw on the existing psychotherapy research. Areas of focus can include:
·         A return to thinking of our programs as delivering therapy and not simply treatment
·         Greater attention to the professional self-development of therapists
·         Increased recognition that society’s attempts to use punishment-only approaches are almost entirely ineffective, while the right therapy and right supervision can make an impact on re-offense rates, community safety, and client well-being.
·         A greater awareness of the role of adverse experiences in the lives of clients and a greater fine-tuning of therapy in order to help clients understand how adverse events have shaped their lives and provide avenues for growing beyond the effects of these experiences.
·         Greater attention to what is important in clients’ lives (e.g., drawing on the Good Lives Model; Ward citation).
In many environments, this will involve a return to viewing therapists as the professionals and experts that they are. After all, the very definition of evidence-based practice includes clinical expertise as well as best available research and in accordance with client characteristics.  
David S. Prescott, LISCW & Gwenda M. Willis, PhD

Beech, A. R. & Fordham, A. S. 1997. Therapeutic climate of sexual offender treatment programs. Sexual Abuse:  A Journal of Research and Treatment 9: 219–237.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16, 252-260.
Gannon, T. A., & Ward, T. (2014). Where has all the psychology gone? A critical review of evidence-based psychological practice in correctional settings. Aggression And Violent Behavior., 19, 435-446.
Gendreau, P., & Ross, R.R. (1987). Revivification of rehabilitation: Evidence from the 1980s, Justice Quarterly, 4(3), 349-407.
Lipton, D.S., Martinson, R., & Wilks, J. (1975). The effectiveness of correctional treatment: A survey of treatment valuation studies. New York: Praeger Press.
Marshall, W. L. (2005). Therapist style in sexual offender treatment: Influence on indices of change. Sexual Abuse: Journal of Research and Treatment, 17, 109-116. doi: 10.1177/107906320501700202
Martinson, R. (1974). "What Works? - Questions and Answers About Prison Reform," The Public Interest, 35, 22-45.
Martinson, R. (1979). "New Findings, New Views: A Note of Caution Regarding Sentencing Reform". Hofstra Law Review, 7, 242-258.
Norcross, J. (2011). Psychotherapy relationships that work, 2nd ed. New York: Oxford University Press.
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., & Miller, S.D. (2015). Feedback-Informed Treatment (FIT) with people who have sexually abused. In B. Schwartz (Ed.), The sex offender, volume 8 (pp. 17-1 – 17-xxx). Kingston, NJ: Civic Research Press.
Salter, A. (1988). Treating child sex offenders and victims. Thousand Oaks, CA: Sage Publishing.
Walfish, S., McAlister, B., O’Donnell, P., & Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110, 639–644.