Monday, February 20, 2017

Investing in people…….


This may not be the sexiest or most appealing sounding blog, but it reminds us of an important point that impacts all of us in our day to day working – workforce development. We would do well to remember that we work in a field were accountability is central, risk management is the name of the game and knowledge is power. We as professionals, practitioners and policy makers need to consistently keep abreast of developments in the field.

Kieran was sitting in a department meeting the other day were we discussed staff workload, programmes and recruitment for the 2017/18 academic year. The meeting focused round the undergraduate provision mainly but we did talk about postgrad teaching, PhD’s, Continual Professional Development (CPD), partnership working, student placements, match funded PhD’s and external training; it made me think about workforce development, which is something that myself and David find ourselves discussing a lot, and what this means for professionals, practitioners and the sexual abuse field in general.

Currently, there is not always enough money in organisations to send their staff to the conferences that they need to, or want to attend. This lack of investment in workforce development becomes more evident when discussing attendance at training events, short courses and qualifications. We remember when business and organisations would pay for members of staff to do MSc/MA or PhD’s as part of work force development; those days are mainly gone now.

Kieran organises a lot of sex offender conferences through the university, the majority of which have been internally funded or funded by research councils (ESRC & Leverhulme trust are two examples), and are in the process of starting to organise a conference that participants have to pay to attend; this has been an interesting experience. What will organisations pay for the training that their staff will be getting? What do they expect for their money? How much of a say do they want in the discussion around content and delivery? In the end they may not charge and find another way to fund it. That may be okay in this instance, but it begs the question of how do staff upskill, become more knowledgeable, and become aware of new research/development in the area. Further, whose responsibility is it to make this possible? This is particularly salient if you work in an area that requires you to have professional accreditation, which psychology, counselling, the legal system and social work (all areas that those that world in child protection and sex offender management tend to come from) do.

An alternative argument that we often hear to training and conferences is that professionals should read more journals, books and literature from their area of work. They should set aside time to develop their own skills base. While we don’t disagree with this, I think that there is more to this than meets the eye. Yes, professionals and practitioners can always read more but there are issues associated with this. For instance, (1) how do they access the articles as many professionals in the field do not have access to a vast array of journals; (2) what articles and authors should they read to diversify their knowledge base to make sure that they are not just reading the industry standard [regardless of how good they are]; (3) who pays for the licences, them or their employer?;  (4) how do they know what they should be reading, by who and when;  and (5) what are they reading for and how do they reintegrate it back into their own/their organisations practice. All of this gets compounded by the fact that most academics publish in pay for journals and books, open access publishing has not reached the mass market yet and those open access publications and not necessarily the ones that academics are encouraged to publish in. I am not criticising either model, both have their pros and cons (currently Kieran sits as an editorial board member and an Associate Editor on two journals with David being an editorial board member on three journals) but it does highlight the fact that professionals and non-academics may not have access to the papers that they need to upskill themselves.

We do not think that sending people on courses and paying for CPD is the only response available to the question of staff development, there are examples of good practice within professional organisations including, article clubs, research Q & A, partnership with academic institutions nearby, support in supervision and annual staff development rounds. What we are  saying is that maybe we need to think differently about how we invest in the development of professional staff in the field so that they have access to resources, training and discussion; so that they can be as up to date and as able to help their clients as possible.

Kieran McCartan, PhD, & David Prescott, LISCW

Friday, February 10, 2017

Q & A with Chantal Hermann entitled "Implicit and Explicit Evaluations of Sexual Aggression Predict Subsequent Sexually Aggressive Behavior in a Sample of Community Men"

Hermann, C. A., & Nunes, K. L. (2016). Implicit and Explicit Evaluations of Sexual Aggression Predict Subsequent Sexually Aggressive Behavior in a Sample of Community Men. Sexual Abuse: A Journal of Research and Treatment.



The current longitudinal study explored the extent to which implicit and explicit evaluations of sexual aggression predict subsequent sexually aggressive behavior. Participants (248 community men recruited online) completed measures of implicit and explicit evaluations and self-reported sexually aggressive behavior at two time points, approximately 4 months apart. Implicit and explicit evaluations of sexual aggression at Wave 1 had small significant and independent predictive relationships with sexually aggressive behavior at Wave 2, while controlling for sexually aggressive behavior at Wave 1. This is the first study to test whether implicit and explicit evaluations predict subsequent sexually aggressive behavior. Our findings are consistent with the possibility that both implicit and explicit evaluations may be relevant for understanding and preventing subsequent sexually aggressive behavior. If these findings can be replicated, evaluations of sexual aggression should be studied with more rigorous methodology (e.g., experimental design) and correctional/forensic populations, and possibly addressed in risk assessment and interventions.

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

Evaluations are an individual’s evaluative thoughts about something such as a person, object, or behavior (e.g., Albarracín, Zanna, Johnson, & Kumkale, 2005; Ajzen, 2001; Gawronski & Bodenhausen, 2007). Social psychology theory and research support the idea that evaluations, in part, predict behavior (e.g., Ajzen 1991, 2001; Glasman & Albarracín, 2006; Kraus, 1995). Empirical evidence suggests this is true whether the evaluations are immediate (implicit evaluations) or deliberative (explicit evaluations), and that both the automatic and deliberative evaluations are important (e.g., Greenwald & Farnham, 2000; Nosek & Smyth, 2007). From this research, my colleagues and I hypothesized that how someone evaluates sexual aggression would predict, in part whether or not they would engage in sexually aggressive behavior.

Prior to this study, we had conducted cross-sectional correlational and experimental research examining implicit and explicit evaluations of sexual aggression against adults. In some of our studies, we found more positive implicit evaluations of rape were associated with self-reported sexually aggressive behavior against adults and self-reported likelihood to rape (Nunes, Hermann, & Ratcliffe, 2013), and in all or our studies we found more positive explicit evaluations of rape were associated with self-reported sexually aggressive behavior against adults and self-reported likelihood to rape (Hermann, Nunes, & Maimone, 2016; Nunes, Hermann, White, Pettersen, & Bumby, 2016; Nunes et al., 2013). These studies provided preliminary evidence that evaluations are related to sexual offending against adults. Prior to this study, however, we hadn’t yet explored whether evaluations predict subsequent sexually aggressive behavior against adults. This was an important next step because if evaluations are a causal factor for this type of behavior, then we would expect that they would predict whether or not people engage in future sexually aggressive behavior.


We also wanted to explore this research question using a sample of men recruited from the community. Sexually aggressive behavior encompasses behaviors that differ in tactic (verbal coercion to physical aggression) and sexual acts (unwanted kissing or touching to penetrative acts). We know that many sexual assaults go undetected, and even if they are detected, may not result in official charges or convictions. This means that individuals with convictions for sexual aggression may not be fully representative of men who engage in sexually aggressive behavior against adults. In our past research we have used student samples, but these samples tend to be fairly homogeneous in their demographic characteristics, so they also may not be fully representative of men who engage in sexually aggressive behavior against adults. Community samples can offer diversity and complement samples of students and men with convictions for sexual aggression.       

What kinds of challenges did you face throughout the process?
There were several logistical challenges we faced while conducting this research. The first was conducting this type of research online with a sample of community men. We needed to be able to get quality data and compensate participants for their efforts. We tried several different methods of collecting data online before settling on using Qualtrics and recruiting from a panel of participants.

 
A second challenge we faced was setting up the implicit measures in the Qualtrics survey environment. We hired a computer programmer to help with the development of these measures, but still had to work closely with the computer programmer to tailor the measures to our needs. We used a combination of computer code (javascript) and pre-existing Qualtrics’ functions to present the blocks and trials, randomize the presentation of stimuli, and record reaction times for our IAT measures.

 
What do you believe to be to be the main things that you have learnt about evaluations of Sexual Aggression in predicting sexually Aggressive Behavior in men in the community? 

 
This research is preliminary, but suggests that explicit and implicit evaluations are relevant for understanding sexual aggression against adults. This is consistent with the social psychology literature noted above and suggests we should continue to explore the role evaluations may play in sexual aggression against adults.

 
This research was part of a series of studies I conducted for my dissertation (also see Hermann et al., 2016; Hermann, 2015). From these studies, we also learned that the pattern of relationships between evaluations and past sexually aggressive behavior and self-reported likelihood to rape was consistent for samples of students and community men. A common critique of research on sexual aggression conducted with student samples is that the results may not generalize to other samples of men (i.e., community or incarcerated samples). The results of the current study suggest that this may not be the case for research exploring the relationship between evaluations of sexual aggression and sexually aggressive behavior. Next we would like to try to replicate these findings with incarcerated samples of men with convictions for sexual aggression against adults to determine if research conducted with students and community men could also generalize to this population.


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

 
We would suggest that more rigorous research is needed replicating and expanding this line of research before there are implications for practitioners. However, if future research finds evaluations predict sexually aggressive behavior against adults, that evaluations of sexual aggression can change, and that change is associated with changes in sexually aggressive behavior, then evaluations of sexual aggression would be an important target in risk assessment and treatment. 

 
Chantal A. Hermann, Ph.D

 
 

References

 

Albarracín, D., Zanna, M. P., Johnson, B. T., & Kumkale, G. T. (2005). Attitudes: Introduction and scope. In D. Albarracín, M. P. Zanna, & B. T. Johnson (Eds.), The Handbook of Attitudes (pp. 3-19). New York, NY: Lawrence Erlbaum Associates.

Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. doi 10.1016/0749-5978(91)90020-T

Ajzen, I. (2001). Nature and operation of attitudes. Annual Review of Psychology, 52, 27-58. doi: 10.1146/annurev.psych.52.1.27

Glasman, L. R., & Albarracín, D. (2006). Forming attitudes that predict future behavior: A meta-analysis of the attitude-behavior relation. Psychological Bulletin, 132, 778-822. doi: 10.1037/0033-2909.132.5.778

Gawronski, B., & Bodenhausen, G. V. (2007). Unraveling the processes underlying evaluation: Attitudes from the perspective of the APE model. Social Cognition, 25, 687-717. doi: 10.1521/soco.2007.25.5.687

Greenwald, A. G., & Farnham, S. D. (2000). Using the Implicit Association Test to measure self-esteem and self-concept. Journal of Personality and Social Psychology, 79, 1022-1038. doi 10.1037//0022-3514.79.6.1022

Hermann, C. A. (2015). Evaluations of rape: Investigations using implicit and explicit measures, online research methodology, and samples of community men (Unpublished doctoral dissertation). Carleton University, Ottawa.

Hermann, C. A. & Nunes, K. L. (2016). Implicit and explicit evaluations of sexual aggression predict subsequent sexually aggressive behavior in a sample of community men. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi: 10.1177/1079063216682952

Hermann, C. A., Nunes, K. L., & Maimone, S. (2016). Examining implicit and explicit evaluations of sexual aggression and sexually aggressive behavior in men recruited online. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi: 10.1177/1079063216681560

Kraus, S. J. (1995). Attitudes and the prediction of behavior: A meta-analysis of the empirical literature. Personality and Social Psychology Bulletin, 21, 58-75. doi:

                10.1177/0146167295211007

Nosek, B. A., & Smyth, F. L. (2007). A multitrait-multimethod validation of the Implicit Association Test: Implicit and explicit attitudes are related but distinct constructs. Experimental Psychology, 54, 14-29. doi 10.1027/1618-3169.54.1.14

Nunes, K. L., Hermann, C. A., & Ratcliffe, K. (2013). Implicit and explicit attitudes towards rape are associated with sexual aggression. Journal of Interpersonal violence, 28, 2657-2675. doi: 10.1177/0886260513487995

Nunes, K. L., Hermann, C. A., White, K., Pettersen, C., & Bumby, K. (2016). Attitude may be everything, but is everything an attitude? Cognitive distortions may not be evaluations towards rape. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi: 10.1177/1079063215625489

 

 

Tuesday, January 31, 2017

Holland and Belgium Are Getting It Right: The 2017 ATSA-NL conference

This week we attended and spoke at the ATSA-NL conference in Utrecht in the Netherlands with Bill Lindsey and a range of Dutch as well as Belgian practitioners.  It was a great opportunity to see and hear about some of the work, research, policy and practice which is going on across the Netherlands and Belgium. The theme of the conference was on the responsivity principle and the current state of public policy and awareness. Kieran spoke on public policy and communication; David spoke about building responsivity and therapeutic engagement.

The conference is vitally important on a number of levels, as it reminds that our field is a truly international one in which the main policy, practice and research issues, as well as our successes and challenges are transferable to other locations. The conference explored the issue of responsivity in the field of sexual abuse deeply. It discussed the role of responsivity in treatment outcome, in the client/practitioner relationship and in how we reintegrate the offender back into the community. The issues raised could have been applied to any sex offender conference, particularly, any ATSA related conference international, including how we get clients to engage, practitioners to be responsivity, policy makers to be realistic and society to support us in our work.

Perhaps most importantly, the professionals of Belgium and the Netherlands demonstrate true grit in making high-quality assessment and treatment happen. Outside the region, these countries have an excellent reputation in research and practice. Once there, we quickly realized how much hard work goes into making excellent services happen.

The conference was held at the Van der Hoeven Kliniek in Utrecht. Many world-famous practitioners have worked there, from ATSA’s own Wineke Smid to Corrine de Ruiter, Vivienne de Vogel, and others too numerous to mention. One of the highlights of the day was having a tour of the facility, meeting the staff, the patients and seeing the work that they do there. To this end, we have to acknowledge the psychiatrist, Jelle Toelstra, who described the incredibly hard work, over many years, that it takes to build a world-class facility and let us interview a number of patients without limitation. The Netherlands and Belgium may have an excellent reputation in our field, but they came by it honestly and in an environment where things can always change.

The Van der Hoeven Kliniek is a therapeutic community and seeing some of the approaches that they use [especially “rock and water”, which we will have an upcoming blog about], the facilities that they have, the training/work based practice that they can offer and the way that they engage with the families of their patients are an important model to follow. The approaches they use, the latitude that they have in their therapy and the trust that is placed in them by the state is impressive. They are an example of good practice that needs to be recognised and shared.

The ATSA-NL conference reinforced the importance of sharing good practice, international collaboration and recognising that sexual harm is a global problem that has local, national and international responses. ATSA-NL grew out of earlier conference/organization work and are bringing practitioners together in a time when budgets are tight and time away from the office is more difficult than ever. The real question is what we (who live elsewhere) need to do to live up to their example.

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

Wednesday, January 18, 2017

What Matters is What’s Missing: The Non-Persistence of Memory


Experts have often commented on the fallibility of memory, from Daniel Schachter’s classic book, The Seven Sins of Memory to Elizabeth Loftus’ TED Talk on the subject. Most of us are aware, at least intellectually, that memory can be flawed. Unfortunately, the discussion seems to end at the point where the fascination fades. Loftus’ showing us that we can’t identify which of the coins that are similar in appearance is the real penny, the convincing memory of your father driving on the right side of the road while vacationing in the UK when you were six — these are easy for us to get our minds around.

A recent internet cascade brought the problems of memory into a different perspective. This time, Reddit readers got into an extended discussion of a 1990s movie called Shazaam in which the celebrity Sinbad had played a genie. The New Statesman produced the story, which was then picked up by other media outlets. The opening of the article is where the implications for the field of assessing and treating sexual violence begin:

In the early Nineties, roughly around 1994, a now 52-year-old man named Don ordered two copies of a brand new video for the rental store his uncle owned and he helped to run. “I had to handle the two copies we owned dozens of times over the years,” says Don (who wishes to give his first name only). “And I had to watch it multiple times to look for reported damages to the tape, rewind it and check it in, rent it out, and put the boxes out on display for rental.”

Don is describing the movie that doesn’t actually exist. What is amazing is not the falsity of the memories, but the extent to which to which people cling to them:
 
“It feels like a part of my childhood has now been stolen from me. How does a movie simply vanish from our history?” This isn’t Don speaking, but another man – who he has never met – named Carl*. Carl, whose name has been changed because he wishes to remain anonymous, recalls watching a movie called Shazaam with his sister in the early Nineties, and has fond memories of discussing it with her over the last 20 years. 

The discussion of this movie apparently began in 2009 on the Reddit web site and escalated to the point where Sinbad had to comment repeatedly that he had not starred in the movie and had never even played a genie. Still, readers cling to the belief that he did, with confidence and vigor. This is where professionals in our field should sit up and take notice.

 
People providing treatment to those who have abused frequently accept nothing less than a complete accounting of a person’s sexual history. In many cases, this extends into accepting only those accounts that match the story of the person they abused. I personally watched as entire teams of clinicians insisted that a client in treatment should not move forward in treatment because his version had not matched the “findings of fact” issued by the court that had convicted him. The concern was not that he was minimizing his behavior and therefore was participating in treatment only superficially; it was that the minutiae of his story did not match those of the person he acknowledged he abused, as filtered through legal documents.


Holding someone back in treatment for the above reason is worrisome given what we know about memory; it simply doesn’t comport with the research. Also concerning is the confidence with which we professionals can assume that a client is actively lying or purposefully downplaying his or her actions. It is worth asking whether it isn’t more important to us to be confident in our certainty than it is to accept the limitations of our knowledge. In other words, no one wants to appear ambivalent or wishy-washy about their conclusions and opinions. Ironically, second-rate reports overflow with confidence, while first-rate forensic reports are written with confidence and openly acknowledge their limitations.


It is worth noting that many professionals in the US (and some other jurisdictions) also rely on the polygraph to verify their clients’ accounts, despite the scientific problems associated with it. Although polygraph advocates rightly point out its ability to elicit more information from clients, we still lack research to conclude that this information is always as accurate or useful as we would like. The fact that there is still no evidence to support the idea that polygraph examinations reduce subsequent abuse is beyond the scope of this blog post.


My point in raising these issues is not to discount the polygraph or the processes it entails. Rather, it seems important to note the many ways in which “the truth” can get lost along the way. People who are abused don’t necessarily remember every detail correctly (we’ll come back to this). People who abuse don’t necessarily recall every detail correctly. People who have been traumatized frequently have problems with memory; it’s a diagnostic criterion for the diagnosis of Post-Traumatic Stress Disorder. People writing the accounts of those who abuse and those who have been abused are not without memory fallibility either, and neither are the people who review those reports, often recycled over the course of years through evaluations and re-evaluations.


On the other hand, the accounts of traumatized people aren’t necessarily wrong either.  Memories of abuse can be vivid and profound. There may be no greater insult to a person who has been traumatized than to distrust their memories. In his recent book, The Body Keeps the Score, trauma researcher and clinician Bessel van der Kolk discusses these facts at length. Professionals who doubt the memories of abuse survivors do their clients no service. After all, many aspects of the memories indeed may be perfectly accurate, or their memory might become fragmented, with some parts dissipating while others linger on, sometimes causing decades of distress the person who lived them.


Adding further insult to injury, Shane O’Mara recently published a review of the many ways that memory fails under high-stress circumstances in his book, Why Torture Doesn’t Work: The Neuroscience of Interrogation. While this may seem out of place, O’Mara draws on findings from diverse areas, including the effects of stress, sleep deprivation, anxiety, and other experiences that are common among clients in and around the criminal-justice system. Taken together, all of these points should raise concern among professionals.

 
As a final point, it is worth noting that my colleagues, Jill Levenson, Gwenda Willis, and I found that males and females who have sexually abused often have a higher rate of adverse childhood experiences in their histories, raising further questions about the effects of their lives on their memories.

 
It may be time to acknowledge once and for all that, while we are quite certain that abuse poses an unacceptable risk of harm to those who experience it, the research shows how much noise there is in our systems as we try to retrieve and understand the details. What’s missing (i.e. understanding the fluidity of memory) from our understanding of clients matters, and sometimes the most confident answer is that we don’t know the complete picture.

David Prescott, LISCW

Friday, January 13, 2017

Q & A with Sandy Jung on “Sexual Violence Risk Prediction in a Police Context”

Jung, S. (2016). Sexual Violence Risk Prediction in a Police Context. Sexual Abuse: A Journal of Research and Treatment. Available from: http://journals.sagepub.com/doi/full/10.1177/1079063216681563

Adoption of evidence-based approaches by police services offers a practical and scientific solution to ensure public safety and proper allocation of resources. Advances in the field of sexual violence risk prediction have the potential to inform policing practices. The present study examines the validity of existing actuarial measures to predict the future sexual violence behavior of 290 identified male perpetrators of sexual assault against adult victims (ages 16 and older). The Static-99R and Static-2002R were coded from police documentation, and the sample was followed up for at least 1 year with an average of 3.6 years. Both measures showed large effects for predicting any offending, violent offending, and sexual offending in the form of charges and convictions. The findings suggest that existing sex offender research can extend to police practice, and criminogenic factors used to predict recidivism among convicted offenders may apply to assessing the risk posed by perpetrators of police-reported sexual assaults.

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

A few years ago, I was fortunate to be asked by the Edmonton Police Service to examine their homicide cases. In working with them, I was able to establish a mutually respectful and trusting working relationship with them. A year later, given the increased calls they received regarding intimate partner violence and sexual assault over the years, they contacted me again to carry out more research. Although their interest was focused more on examining the profile of reported cases, I was very much interested in examining the application of risk assessment in the police context, as I was already collaborating with a provincial law enforcement agency. When I pitched this idea, they became quite interested as well, and I was given the opportunity to access their police database to carry out the research.

What kinds of challenges did you face throughout the process?

I’m more familiar with correctional and outpatient forensic settings, so one of the things I found challenging was learning about the policies and politics in the police context—in essence, I had to immerse in the police culture at the service. I was lucky as I was eligible for a sabbatical leave and applied for one with the goal of conducting research at the Edmonton Police Service. The learning curve was huge and it was critical for me to understand how the police organization worked in order for me to truly do meaningful and impactful research.

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

It was an interesting experience for me, as I collaborate a lot with other researchers who are often friends or become good friends, or else I work very closely with my students. I greatly enjoy the collaborative process, and I also find that collaborating provides a nice safety net because I can bounce things off my collaborators or my students to ensure I’m doing the right thing or I haven’t missed something. But this particular research started as a solo project during my sabbatical leave. I was able to dedicate a lot of time to it, but I was mostly on my own in developing the coding strategy I would end up using to collect and code the data.

The fortunate thing was that the research was focused in an area that I was already familiar with. Given my research on threat and risk assessment in policing (I currently collaborate with Drs. Ennis, Hilton, and Nunes), this was an easy application to the sexual violence risk field, with which I was more familiar.

What do you believe to be to be the main things that you have learnt about Sexual Violence Risk Prediction in a Policing?

Prioritizing police-reported cases of sexual violence is necessary given the finite resources available to police. Taking from the RNR principles used in correctional psychology, it makes sense to use evidence-based practices, such as validated risk assessment tools, to prioritize resources to sexual assault cases where there is an identifiable perpetrator. The risk principles highlights that we should be aware of who should receive the most resources and such tools can be invaluable to police in their service-intensive work to reduce further sexual victimization. This research supports the use of these tools at the front line where early intervention responses can prevent further assaults committed by the same perpetrator.

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

In this case, practitioners are law enforcement. Borrowing from intimate partner violence research, we know that police are capable of reliably using actuarial measures of risk in their work. So the implications from this research suggests that police officers can use evidenced-based practices, that are extracted from sexual violence research conducted in correctional and forensic settings, in their work to both efficiently use their resources and make defensible daily decisions with the goal of preventing further sexual assaults.

Sandy Jung, PhD, RPsych

Friday, January 6, 2017

Reflecting back on 2016 & moving forward into 2017

Welcome to the first blog of 2017 where we are going to reflect upon our favourite articles from 2016, and consider the impact that they may have, on us personal or the sexual harm field, in moving forward into 2017.
Kieran McCartan, PhD
At ATSA 2013 I saw Nicole Pittman talk, she was discussing her report “Raised on the Registry” which highlighted the impact of disclosing juvenile sex offender information in the USA. Nicole’s report struck me as it highlighted a very punitive practice with massive societal community and individual impacts; particularly as we do not publically disclosure the information of sex offenders, especially that of youths,  in the UK in the same way as the USA. I thought that the recently published article by Harris, Walfield, Shields and Latourneau entitled “Collateral Consequences of Juvenile Sex Offender Registration and Notification: Results from a survey of treatment providers” (Sexual Abuse: A Journal of Research and Treatment, 28, 770-790) was a good counterpoint to Nicole’s report. The article by Harris et al highlighted, again, the negative impact that community notification of juvenile sex offender information has on the person in question as well as their community but this time from treatment providers. The insight that that treatment providers brings to this argument is important as it can help shape policy and practice in this arena, with policy makers hopefully being more inclined to listen and support change. The Harris et al paper also reinforces the importance, as well as negative consequences, of language, social policy, risk management and politics in how we deal with sexual harm (“sex offender”, “Juvenile sex offender” etc), which was also highlighted in other 2016 SAJRT papers ( Zgoba et al; Harris& Socia; Hoing, Bogaerts & Vogelvang). The Harris et al paper refocused me for 2017, it remaindered be that there is still a distance to be travelled in getting realistic sexual harm policy and practice across the board for high profile  offenders (i.e., middle aged, white child sexual abusers), never mind  what may be considered  by sections of society as “fringe” offenders (i.e., juveniles, females, learning  disabled).
David Prescott, LISCW
For this year, I am going well outside the usual scope of our “best of” series. It may seem off topic, but I think this study by Goldberg, Miller, Nielsen, Rousmaniere, Whipple & Hoyt called Do Psychotherapists Improve with Time and Experience?”  (Journal of Counseling Psychology, 63,1-11) is very important to know about. Here’s why:
Goldberg and his colleagues studied whether therapist experience is linked to improved outcomes for clients in general psychotherapy (i.e. not abuse-related). They followed 6,591 patients seen in individual psychotherapy by 170 therapists over nearly five years. To date, no large-scale longitudinal study has assessed whether the amount of professional experience of the therapist would improve outcomes over time.
The study found that psychotherapy was effective overall. Unfortunately, therapists did not improve with experience. In fact, therapists became slightly less effective over time (although the authors note that the level of this decrease was extremely small). The authors also note that these results contrast with clinician self-reported experiences with clients. In short, therapists believe they become more effective over time; these results suggest otherwise.
Clearly, effective treatment of people who sexually abuse is a matter of public safety as well as a means to help individual clients manage their lives. This study should serve as a warning that practitioners can easily be lulled into a sense of complacency about their effectiveness; confidence can improve across one’s career, competence may not. In our work, we should always remember that getting better at avoiding mistakes is not the same as becoming more effective at developing the clinical skills that lead to successful treatment completion for our clients.
Jon Brandt, LISCW
This year, my pick for the most noteworthy journal article of 2016 is an easy one: “Quantifying the Decline in Juvenile Sexual Recidivism Rates,” (Psychology, Public Policy, and Law; July 18, 2016).  Michael Caldwell (University of Wisconsin, Madison) reviewed 106 international recidivism studies involving more than 33,000 juveniles who have sexually offended, and determined the mean five-year sexual recidivism rate for offenses committed over the last 30 years is less than 5%.  Looking at the most recent 33 studies, since 2000, Caldwell determined a mean sexual recidivism rate of 2.75%, and, “This suggests that the most current sexual recidivism rate is likely to be below 3%.”  Another important finding was that follow-up periods beyond 36 months did not significantly increase recidivism rates.  The implications of this study are significant and are the subject of a SAJRT blog 8/12/16.
Current policies and practices driving the assessment, treatment, and management of juveniles with sexual offenses are still predicated on beliefs that they are likely to sexually reoffend.  If, as a group, 97% of juveniles don’t sexually reoffend, what’s the takeaway from this research?
Caldwell’s research also indicates that general delinquency IS positively correlated to sexual reoffending, and even with sexual recidivism below 3%, the Risk-Needs-Responsivity model is still useful in determining NEEDS and RESPONSIVITY.  It is likely, that a small percentage of juvenile offenders have high needs, however, perhaps the seven out of ten juveniles who do not have concurring general delinquency, might benefit from some psycho-sexual education, and otherwise deserve a speedy exit from the juvenile court system.  For the majority of juveniles with sex offenses, intensive treatment, long periods of supervision, and onerous conditions of probation, are essentially unwarranted, and may even set them up to fail, e.g. sex offender registration and notification laws are not only unfounded, they are profoundly counterproductive.  Public perceptions and engrained practices die hard, but hopefully, professionals throughout the juvenile justice system will use this conclusive research to guide sound dispositions. 

Tuesday, December 20, 2016

Star Wars and Sexual Abuse Treatment

Weary from many long hours of assessments, treatment, travel, and training, I went with my family to see the new Star Wars movie. I’m a dreadful Star Wars fan; most of the time I smile my way through these movies because I don’t know what’s going on. They are pleasant to look at though, and remind me of when I waited in line for an hour or more to see the very first one in the theaters in the late 1970s, probably wearing the fashions of the times: an oversized down jacket and light-colored Frye boots.

Four decades on, I found myself resentful. Why are these characters considered heroic when my colleagues aren’t? After all, the people I work with may occasionally make mistakes or become misguided, but every one of them puts their all into a shared mission of healthier lives and safer communities. As many have observed, the beneficiaries of our work will never know to say thank you because they won’t have been abused. My colleagues are not, as one defense attorney in Wisconsin once said to me, the “Death Star.” The vast majority of people working from all perspectives towards the goal of eliminating abuse are all over-worked and under-paid. Maybe it’s that our costumes and transport aren’t as cool as the Star Wars characters. I’m quite certain I would not look as lithe climbing up the ladder of a spaceship as some of the figures in the movie.

Then I realized the difference: These characters don’t have to do case notes. They don’t know from DAP and SOAP formats, and couldn’t formulate a SMART goal if Princess Lea’s life depended on it. To my knowledge, there are no ethics-codes considerations around the use and misuse of protocol droids… or any robots for that matter. These characters have never done paperwork, nor worked with someone whose job involves cracking the whip on therapists to submit their documentation. It’s no wonder they’re all so attractive and confident. They’ve probably never had to write or review an incident report after a long shift!

Meanwhile, while we are working, no one who observes us is moved to eat popcorn. When we solve problems, we don’t know if they are actually solved until the researcher (probably from Canada) with the statistical-analysis package says it worked. But that is only 15 years into the future, and even then the final report will say that “more research is needed.” It’s deeply unfair; Star Wars doesn’t have a meaningful control group… and I don’t even get to have a John Williams soundtrack! All I get is the occasional Survey Monkey request for a research project studying PTSD symptoms of professionals in our field. And worse, no one is studying the dirty little secret of our work: the most piquant symptoms of trauma often come not from vicariously reliving the worst moments of others’ lives, but from our interactions with state licensing audits.

Although I have known some professionals who might be deserving of an award for their ability to bring drama into the workplace, I have to conclude that my colleagues are people whom few know to thank for their efforts. My neighbors and family long ago learned to be very careful about asking me how things are going at work, as the answer might cause them to dissociate. As I have joked many times, describing our work to an outsider often “makes their face go straight to screen-saver.” Indeed, we often forget how much work goes into protecting the sensitivities of those around us. Thanks to our professional boundaries and ethics, there is no room for anything that sounds like “Rogue One” in our field.

We may give up some dreams going into the work of eliminating sexual abuse, but I would argue that our dream is better and in some ways already coming true. The ordinary heroes that work in our field can point to a track record of reduced violence across the time since the first Star Wars movie came out. We can’t always prove that it was our efforts, but we are definitely part of the trend.

I hope everyone has a wonderful Holiday Season… and then gets back to this excellent, meaningful work.


David S. Prescott, LICSW