Wednesday, October 15, 2014

Public Engagement and Changing Attitudes about Sexual Abuse

Sexual abuse is a complex and emotional public health issue that impacts everyone – individuals, communities, institutions, and society as a whole. Despite this reality, sexual abuse remains a difficult topic for open discussion and the complexities of sexual abuse are often not reflected by public opinion. This is understandable when we recognize that our perceptions are often influenced by the way sexual abuse, sexual abusers, and survivors are portrayed in films, on television, and in the popular media – too often a one dimensional and sensationalized, rather than factual, presentation. If our goal is to prevent sexual abuse and ensure there are no more victims, it is essential that the public become engaged and educated about sexual abuse, those who perpetrate sexual abuse, and strategies to prevent sexual abuse.

Studies have shown that reported offending has decreased for all types of crimes over the past 20 years and this is also true for sexual offending, both in the United States (Finklehor, 2004; Lauritsen & Rezey, 2013) and the United Kingdom (Crime statistics for England and Wales, 2013/14). Research on sexual abuse within the criminal justice and psychology fields has also vastly progressed over the past 30 years (Wilson & Prescott, 2014; Marshall, 2011) and we now know more about those who perpetrate sexual abuse,  their motivations, etiology and rehabilitation than ever before (ATSA, 2014; Wilson & Prescott, 2014; Carter, 2014). We also have more clearly defined laws and evidence-based criminal justice approaches for the management of individuals convicted of sexual crimes than ever before (CSOM, 2008; Kemshall & McCartan, 2014), as well as a greater understanding of innovative reintegration strategies that promote public safety, including community-based strategies such as Circles of Support & Accountability. We are even starting to see the traditional media reporting on sexual abuse in a more balanced, realistic, and engaged manner.

Despite these positive changes towards greater community engagement and understanding, improved victim services, and more effective treatment models, the most common attitude of the general public continues to be that nothing works for “sex offenders.” (McCartan, 2004, 2010, 2013; McCartan, Kemshall & Hudson, 2012). This is the greater paradox within our field, as well as criminology/criminal justice in general – public perceptions do not coincide or reflect professional experiences, or what the research tells us about the reality of the situation. 

This divergence between public attitudes and understanding versus the realities of sexual abuse is fuelled in part by myths created through stereotyping, miscommunication, prejudice, active disengagement, and poor professional interaction – all factors which speak to the need for greater public engagement and understanding about sexual abuse in order to facilitate prevention and safer communities. Public engagement is important for a number of reasons, including;

·         Community and self-protection: By better understanding the aetiology, behaviours, offence patterns, criminal justice responses and treatment models related to sexually abusive behavior, individuals are better prepared to protect themselves and others. Therefore education and understanding is a self-defense mechanism, as well as an integral component to creating a culture of non-acceptance of sexual abuse which promotes prevention (e.g., bystander intervention programmes).

·         Supporting appropriate responses to sexual abuse: The appropriate response to sexual abuse, like any crime or case of neglect, is to report it to the appropriate authorities so that they can respond to it. It is not to take the law into your own hands (McCartan, 2010; Vigilante hunter case, Daily mail, Independent; Haas, 2010) or too ignore the issue. By better understanding what the reality of sexual abuse is, what the authorities do (and why they do it in that way), and how sexual offense specific treatment and management works,  the public is better equipped to make informed decisions, as opposed to uninformed ones.

·         Dispelling miscommunications and rectifying myths: Sexual abuse has a lot of associated myths, whether these are rape myths, victim blaming, myths about who commits child sexual abuse, or the impact of abuse depending on the gender/age/ethnicity/cognitive ability of the offender or victim. These myths help no one and actually often compromise, rather than promote, public safety. By greater engagement with individuals and communities, through better education programmes and through more realistic media engagement, we can dispel these myths. While this may be a difficult task due to many of these myths being hardwired into our personal and cultural psyche, by dispelling these myths we can facilitate recognition of sexual abuse for the complex public health issue that it is and move forward towards a culture of prevention.

·         Influencing public policy and agenda setting: Public opinion shapes governmental policy and practice, from emotionally driven knee jerk responses to in-depth social change. This means that public opinion is vital beyond a social dialogue as it feeds into legislative and political agenda setting. A more engaged public results in a greater understanding of the reality of sexual abuse and the complexities of responding to these issues and this, in turn, leads us to a more informed and realistic sociological debate. It also results in the public campaigning for evidence based policies and laws that are both preventative and responsive, public health oriented as well as criminal justice oriented, and forward thinking rather than reactionary. 

While the prevention of sexual abuse may feel like a never ending task, we have come far over the past 30 years in not only our understanding of sexual abuse, but in our support of survivors, management of perpetrators, and prevention efforts. But our work is far from done and public engagement is key to continuing forward – although the prevention of sexual abuse requires a well-planned and comprehensive response founded on research, it is only through education, collaboration, and the involvement of everyone – community members, violence prevention professionals, victim advocates, law enforcement professionals, treatment professionals, journalists, and policy makers – that the prevention of sexual abuse can become a reality.

Interested in learning more about public engagement? Then join us for a free event open to all - Understanding Sexual Abuse & Sexual Assault: Causes, Consequences, and Prevention - on Tuesday October 28th at the Manchester Grand Hyatt in San Diego, CA. Co-sponsored by ATSA, CALCASA, CCOSO, IVAT, and NSVRC.

Kieran McCartan, PhD & Katie Gotch, MA


Association for the Treatment of Sexual Abuses (ATSA) (2014). Eight things everyone should know about sexual abuse and sexual offending. Beaverton, OR: Author.

Carter, A. (2014). Sex Offending Treatment Programmes: The importance of Evidence based practice. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 111 - 126. ISBN 9781137358127

Center for Sex Offender Management (CSOM) (2008). The comprehensive approach to sex offender management. Silver Spring, MD: Author.

Finkelhor, D. & Jones, L.M. (2004). Explanations for the decline in child sexual abuse cases. Juvenile Justice Bulletin, January 2004. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Haas, N.E. (2010). Public support for vigilantism. Leiden: Universiteit Leiden.
Kemshall, H. and McCartan, K. (2014) Managing sex offenders in the UK: Challenges for policy and practice. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 206-226. ISBN 9781137358127

Lauritsen, J.L. & Rezey, M.L. (2013). Measuring the prevalence of crime with the National Crime Victimization Survey. US Department of Justice, Bureau of Justice Statistics.
Marshall, W. (2011). Milestones in Sexual Offender Research and Treatment. Keynote at ATSA Annual conference. Toronto, Canada.

McCartan, K. (2004) Here there be monsters: The public's perception of paedophiles with particular reference to Belfast and Leicester. Medicine, Science & the Law,  44. pp. 327-342. ISSN 0025-8024
McCartan, K. (2010) Student/trainee-professional implicit theories of paedophilia. Psychology, Crime & Law, 16 (4). pp. 265-288. ISSN 1068-316X

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

McCartan, K., Kemshall, H. and Hudson, K. (2012) Public understandings of sexual abuse and sexual abusers. ATSA Forum, xxiv (3) McCartan, K. (2014) Euthanasia & sexual abusers. Journal of Sexual Abuse blog, 2014 (Sept).

Wilson, R., and Prescott, D. (2014). Community based management of sex offender risk: options and opportunities. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 20 - 47. ISBN 978113735812 

Friday, October 10, 2014

Protective Factors: A “New” Discovery?

Readers may be interested in de Vries Robbé, Mann, Maruna, and Thornton’s (2014) recent article, "An exploration of protective factors supporting desistance from sexual offending," currently published in the online first section of Sexual Abuse: A Journal Research and Treatment (SAJRT). This is actually one of a series of articles written by de Vries Robbé and various colleagues, but possibly the first in the “series” that specifically focuses on the role of protective factors in work with sexual offenders. In fact, Thornton (one of de Vries Robbé’s co-authors in this case) published an article last year (2013) discussing the implications of a model that recognizes both risk and protective factors in the treatment of adult sexual offenders, asking how treatment tasks might be revised “in light of this new knowledge” (p. 62). Similarly, focusing on the idea of “new knowledge,” Worling and Langton (2014) write that research into protective factors for sexually abusive youth is only in its earliest stages. Actually, Spice and colleagues (2012) might have been the first to point to the complete lack of research into the subject of protective factors, at least with respect to sexually abusive youth, and van der Put and Asscher (2014) are among the first to correct this situation in their study, examining the nature and effect of protective factors in the behavior of sexually abusive youth.


The addition of a literature that addresses and incorporates ideas about protective factors, and not just risk factors, in sexual offender assessment is welcome, a topic area to be further addressed in a forthcoming special theme issue of SAJRT. But, it seems important to add that although relatively new to sexual offender risk assessment, the idea is not especially new (and really not even that new to sexual offender assessment and treatment, at least not for those practitioners who work with sexually abusive youth). Although it may be accurate to say our empirical and theoretical examination of protective factors is new, the existence and function of protective factors in assessing risk is certainly not “new knowledge,” as Thornton described it. Rich (2003) wrote about protective factors over a decade ago, and in additional detail in 2009 and 2011. Furthermore, protective factors have been built into several juvenile risk assessment instruments since around 2001 with the introduction of the AIM assessment protocol, used in the UK, and further developed in the AIM2, revised in 2007. Similarly, the SAVRY, a general (non-sexual) adolescent risk instrument in use for over a decade, has included a table of protective factors since the instrument was released in 2002. The J-RAT, a juvenile sexual risk instrument in use since about 2000, has included a protective factor scales since 2012, as does the MEGA, a more recently introduced juvenile sexual risk instrument. Although neither are widely used, Bremer's Protective Factors Scale (1998, 2006) and Gilgun's (1999) Clinical Assessment Package for Client Risk and Strengths offer additional examples of instruments built around the presence of and designed to assess protective factors, both of which have been around for a number of years. In the world of adult sexual risk assessment, the ARMIDILO-S, designed for use in the assessment of intellectually disabled adults, has included an assessment of protective factors since its inception in 2004, as does the currently in-development youth version of the instrument.


So, what point is being made here? Just that the recent and happily expanding attention being paid to protective factors in our literature neither represents new knowledge nor recent innovation in the field of risk assessment or treatment. Jessor and colleagues discussed protective factors in understanding troubled adolescent behavior back in 1995, and in 2003 Rutter wrote of the obvious need to pay attention to protective factors, as well as risk factors. Going back a few years earlier still, in their exploration of resiliency among troubled and high-risk children Werner and Smith wrote about protective factors and relationships in 1992. This protective factors, or strength-based, approach to assessment and treatment recognizes that there is more to risk than risk alone, and more to treatment than simply containing risk. Instead, it tells us that we must recognize and assess factors that not only protect against risk, but also increase the likelihood of desistance from continued problem behaviors. It is gratifying to see increasing attention being paid to the presence and nature of protective factors and the mechanisms by which they harness or increase resiliency, but it is also oddly disturbing that we seem to have only recently "discovered" ideas that have actually been there all along, even within our own field. These are not new ideas; we just seem to have not "noticed" them before, or been too busy looking at other things to notice them, or perhaps simply unaware of the larger mental health field and the field of human development around us. It is possible that this has something to do with the formerly very narrow field of vision that has permeated and perhaps defined sexual offender treatment, and especially the treatment of adult sexual offenders.


An increasing awareness of protective factors, and an increasing prominence in our research, is welcome. However, protective factors have been there all along; they have already been “discovered.” The current task involves, not discovery, but better understanding protective factors, empirically and in clinical practice, including not only what we should count as protective factors, but also how they work and, importantly, how they interact with one another and how they interact with risk factors. It is this focus that most represents the area of new knowledge – not the discovery of protective factors, but instead how they work, and under what circumstances.

Phil Rich, EdD., LICSW



Bremer, J. F. (1998).  Challenges in the assessment and treatment of sexually abusive adolescents.  The Irish Journal of Psychology, 19, 82-92.   doi: 10.1080/03033910.1998.10558172

Bremer, J. (2006). Protective Factors Scale: Determining the level of intervention for youth with harmful sexual behavior. In D. S. Prescott (Ed.). Risk assessment of youth who have sexually abused (pp 195-221). Oklahoma City, OK: Wood & Barnes.

de Vries Robbé, M., Mann, R. E., Maruna, S., & Thornton, D. (2014). An exploration of protective factors supporting desistance from sexual offending. Sexual Abuse: A Journal of Research and Treatment. Advance online publication. doi: 10.1177/1079063214547582

Gilgun, J. F. (1999). CASPARS: Clinical assessment instruments that measure strengths and weaknesses in children and families. In M. C. Calder (Ed.), Working with young people who sexually abuse: New pieces of the jigsaw puzzle (pp. 50-58). Dorset, England: Russell House Publishing.

Jessor, R., Van Den Bos, J., Vanderryn, J., Costa, F. M., & Turbin, M. S. (1995).Protective factors in adolescent problem behavior: Moderator effects and developmental change. Developmental Psychology, 31, 923-933.         

Rich, P. (2003). Understanding juvenile sexual offenders: Assessment, treatment, and rehabilitation. Hoboken, NJ: John Wiley & Sons.

Rich. P. (2009). Juvenile sexual offenders: A comprehensive guide to risk evaluation. Hoboken, NJ: John Wiley & Sons.

Rich, P. (2011). Understanding juvenile sexual offenders: Assessment, treatment, and rehabilitation (2nd. ed.). Hoboken, NJ: John Wiley & Sons.

Rutter, M. (2003). Crucial paths from risk to causal mechanisms. In B. B. Lahey, T. E. Moffitt, & A. Caspi (Eds.) Causes of conduct disorder and juvenile delinquency (pp. 3-24): Guilford Press.

Tuesday, September 30, 2014

Euthanasia & sexual abusers

Frank van der Bleeken is an imprisoned murderer and multiple rapist residing in Belgium. He he committed his sexual offences against young women in Antwerp (Belguim) during the 1980’s. Mr. van der Bleeken was sentenced to life imprisonment and has already been in prison for over 30 year’s (International Business Times). Recently, Mr. van der Bleeken successfully petitioned the Belgian government to be given allowed the right to die via assisted suicide through their euthanasia law (Belgian Act of Euthanasia, 2002; Cohen –Almagor, 2009). Euthanasia is controversial in and of itself, regardless of its use by offenders, with disagreements within and between countries about its legality as well as morality (The Lancet, Medical News Today and Mr. van der Bleeken’s argument for euthanasia is based upon his belief that he was not receiving adequate treatment for resolve his sexually abuse impulses (which is an issue in Belgium - The Globe and Mail), that these sexual impulses where not diminishing and that he was suffering significant psychological as well as emotional trauma as a result of this (The Sydney Morning Herald). In his application Mr. van der Bleeken was supported by medical professionals who supported his claim that his condition was not improving and that treatment was having no impact (The Sydney Morning Herald).


The decision by Mr. van ver Bleeken’s to seek euthanasia as a response to his sexually abusive raises a whole host of questions as well as issues for sex offender treatment, rehabilitation and reintegration:


-       Mr. van der Bleeken’s argument is that his sexual impulses are innate and causing him severe psychological as well as emotional trauma, as a consequence he is asking to be euthanatized so that his pain can be abated. In saying this he is placing his sexual cognitions and motivations in the same arena as other prolonged and depilating illnesses, such as MS, which euthanasia is used for. This reframes sexual abuse, and the related motivations, into a whole new biological light. Although, we recognise that there may innate drives that can motivate some sexual offenders this is not the case for all sexual offenders; sexual offending is heterogeneous in nature. Mr. van der Bleeken’s argument for euthanasia as well as being reductionist also works to cloud the fact that there are social aspects to sexual abuse. So even though he may suffer from cognitions and drives that are emotionally and psychologically based, so to do a lot of other individuals (i.e., people with severe personality disorders, schizophrenia, depression, etc) for whom euthanasia would not be considered. So why was euthanasia allowed for Mr. van der Bleeken? As a consequence of the nature of his offences, or his level of dangerousness, or his risk level? These seem difficult to justify, especially in a country that does not have the death penalty.


-       In this case the argument is that treatment has not help Mr. van der Bleeken and that another response is needed. Research has indicated that treatment works for different individuals in different ways at different times (Beech et al, 2009; Baim & Guthrie, 2014); it is not a homogenous solution. However, the suggestion that death is the only alternative solution to a failure in treatment is a very worrying precedent to set and feeds into the longstanding, although often rebuked, myth that nothing works with sex offenders so why bother. As professionals we recognise that sexually abusive tendencies and cognitions are incurable, and therefore that is not what treatment is really about; treatment is really about giving people the skills to reduce and manage these tendencies. Therefore it is a misnomer to say that the inability of treatment to cure a sex offender means that we must move to the most radical solution, death. This is why we have some individuals who are civilly commitment for their own as well as society’s benefit, which is not to say that everyone who is civilly committed is always going to be high risk forever but instead to say that those most resistant to change and in need of the most support have the appropriate responses available to them.


-      This case also raises the issue of prisoner rights, so should Mr. Van der Bleeken be allowed to pursue this course of action when he is being held by the state for a crime(s) that he committed? Part of the role of prison is to remove an individual’s freedom and right for self-determination. However, prisoners do have health related rights and therefore are Mr. Van der Bleeken’s concerns over his emotional and psychological state congruent with prisoners suffering for physical ailments for would euthanasia would be more readily accepted? Or is it an attempt to downplay his responsibility for the sexual assaults as he cannot control himself and his urges are beyond treatment? So in arguing for assisted suicide Mr. van der Bleeken could be seen as bypassing the criminal justice system as the Belgium government do not think that the death penalty is not an appropriate response to his offences. However this goes beyond the offender and the state to the victim, with the parents of Mr. van der Bleeken’s victims not wanting him to have access to assisted suicide instead arguing that he needs to serve out his sentence and be punished for his offences (Daily Mail). Consequentiality, the Belgian government’s recommendation that Mr. van der Bleeken can be allowed euthanasia means that the families of his victims feel betrayed by the criminal justice system and that they are not getting the justice that they were originally promised.


The Frank van der Bleeken case raises a lot of questions about the viability and impact of sex offender treatment (The Globe and Mail). The main issue seems to be whether euthanasia is appropriate response if sex offender treatment is not seen as successful by the client. This could have serious implications for the view of treatment from the judiciary as well as from the public, because if sex offenders feel that they deserve the death penalty and that they cannot be cured is this probable cause to invoke it?




Beech, A.R., Craig, L.A., & Browne, K.D. (2009). Assessment and treatment of sex offenders: A handbook. Chichester: Wiley.


Baim, C., & Guthrie,L.  (2014). Changing Offending Behaviour. London: Jessica Kingsley.


Cohen –Almagor, R. (2009). Belgian euthanasia law: a critical analysis. Journal of Medical Ethics, 35, 436-439



Friday, September 19, 2014

The Community and the “Cure”

In a recent television interview, a talk-show host asked boxer Mike Tyson why people should take his opinions seriously when he is a “rapist.” This referred to a crime that Tyson committed over two decades ago. Tyson’s response was swift and characteristic of his career; he insulted the interviewer and challenged him to a fight. Although the situation was unfortunately and entirely unnecessary, it demonstrated what research has found: people change, and violence and aggression are more likely to persist than sexual abuse. Mike Tyson may have persisted in many undesirable behaviors, but he has apparently desisted from further sexual abuse. Tyson objected to the label “rapist,” and perhaps we should as well.

In the interest of accurate language, Mike Tyson is a person who has been violent towards others in and out of the boxing ring. Sexual abuse is an area where, as Bill Marshall (personal communication, September 11, 2014) recently observed, our labels stick like glue. It is fascinating that the interviewer used this particular label rather than asking, “Why should people take your opinions seriously when you’ve bitten off parts of your opponents’ ears and assaulted strangers on the side of the highway?” Perhaps part of the answer lays in public ignorance about how sexual re-offense does – and more importantly – does not happen.

Relevant to this is a study (in press) that merits close attention. Karl Hanson, Andrew Harris, Leslie Helmus, and David Thornton studied 7,470 sexual offenders from 21 samples and found that:

The risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offence-free in the community. This pattern was particularly strong for the high risk sexual offenders (defined by Static-99R scores). Whereas the 5 year sexual recidivism rate for high risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offence-free in the community for 10 years. The recidivism rates of the low risk offenders were consistently low (1% to 5%) for all time periods. The results suggest that offence history is a valid, but time dependent, indicator of the propensity to sexually reoffend.

Certainly, official records of re-offense underestimate the true rate of sexual crimes. However, the overall trends in this study reflect what we already know from numerous other studies around the globe. Most sexual offenders are not known to re-offend, and only a small minority is at truly high risk. This presents many opportunities for reconsidering our current approaches to management, including the use of strategies that reduce risk, protect communities, and help assist those affected by sexual abuse that are more efficient and cost-effective than the many ineffective strategies in place today (e.g., residence restrictions).

These findings should prompt all professionals and the lay public to reflect on their beliefs about people who sexually abuse. Until recently, Colorado statutes stated that, “there is no cure for sex offending,” as though it were a disease instead of a preventable behavior. Likewise, by the time someone reads this blog, it is highly likely that they have heard the expression “once a sex offender always a sex offender.” Although even one sex crime is one too many, this study shows that short-term and intensive strategies for preventing sexual re-offense (such as high-quality treatment and sensible community supervision) are more likely to be effective than long-term, passive, and as-yet unproven methods such as Internet registries. 

Further, this study shows the opposite side of a familiar coin. Prisons and other forms of punishment do not actually reduce crime (Smith, Goggin, & Gendreau, 2002). However, time spent successfully in the community is associated with desistance from crime. Recent research has highlighted the success of many community-based programs and their emphasis on developing a balanced, self-determined lifestyle (Wilson et al, 2009). This study points to the importance of using treatment and supervision to expedite desistance-related processes (such as stability, staying occupied, having prosocial supports, and implementing plans for self-improvement) rather than simply as tools for monitoring behavior.

Human beings naturally default to detecting and managing risks in the short term.  Current research into assessment methods has helped us become even more adept at understanding and categorizing these risks. Developing effective means to ensure long-term public safety has taken longer. The most effective means for managing risks has presented far more challenges in our research and practice as well as the way we think about individual cases (such as Mike Tyson). Hanson and his colleagues’ findings point to the next steps we can take in supplementing our knowledge of risk with skillful reintegration.

As a final note, it is again important to note that not every crime is detected. However, it is noteworthy that these findings extend across all risk categories in a large sample and speak to the importance of allocating our most intensive resources to those who need them the most.

David S. Prescott, LICSW


Hanson, R.K., Harris, A.J.R., Helmus, L., & Thornton, D. (in press). High risk sex offenders may not be high risk forever. Journal of Interpersonal Violence.

Smith, P., Goggin, C., & Gendreau, P. (2002). The effects of prison sentences and intermediate sanctions on recidivism: General effects and individual differences. Research Report 2002-01. Ottawa, ON: Solicitor General Canada.

Wilson, R. J., Cortoni, F., Picheca, J. E., Stirpe, T. S., & Nunes, K. (2009). Community-based sexual offender maintenance treatment programming: An evaluation. (Research Report R-188). Ottawa, ON: Correctional Service of Canada.

Friday, September 12, 2014

The international dimensions of sexual abuse

Sexual and interpersonal violence are global issues with the capacity to affect anyone regardless of cultural, gender or social background. This means that sexual and interpersonal violence are part of the human condition as opposed to being specific to any given society. Although, how we prevent, discuss, report, treat, punish and reintegrate in respect to sexual offending will differ based upon geographical location as well as social context (ESRC Online Debate 4). We are starting to see an increase in the awareness of the reality of sexual abuse that transpires intentionally (i.e., in India and the recent revelations about ISIS). Recently UNICEF released a report on the degree of sexual and interpersonal violence globally based on data from 190 countries (Hidden in plain sight). The data is collected for an array of existing national and international data sources, not from the creation or distribution of new surveys. This means that the data is an accumulation of what we already know and therefore is not necessarily as up to date or rigorous as it could be. Important factors to keep in mind when examining this type of report, or data set, are that;

-           the same data was not available for all 190 countries, so the more developed and data driven the country is the more it will be represented in the report;

-          different countries record data at different points and in different ways;

-          there are different terms, categories and definitions of sexual abuse used in different countries;

-          there are different cultural barriers or sensitivities surrounding the discussion of sexual abuse in general, but particularly in regard to certain types of sexual abuse (i.e., male rape) and the gender of victims (i.e.., girl and female sexual victimisation as opposed boy and male victimisation).

The data presented in the UNICEF report therefore comes with its own health warning; it is a snapshot of the current global picture of sexual and interpersonal violence, not the complete picture. The key data is available in the report, but I would like to focus on the sexual abuse data specifically (see chapter 4 of the report for more detail);

-          Sexual abuse against children is not just limited to girls but that boys are impacted too. The report indicates that boys are subject to sexual violence at a lower level than girls and that boys are an under recognised population in respect to sexual abuse victimisation (reinforcing a recent comment by Barnardo’s - independent).

-          In the countries where data was available the majority of children who were victims of sexual abuse where aged between 15 -19 at the time.

-          In the countries where data was available the majority of children who were victims of sexual abuse the perpetrators was an intimate partner or someone known to them.

-          In the countries where data was available the majority of children who were victims of sexual abuse reported that the abuse occurred in everyday locations (i.e., the victim’s home, the home of the perpetrator, home of another known person or on route to a familiar location with a known person).

-          In the countries where data was available the majority of girls (15 – 19) who were victims of physical violence where not necessarily victims of sexual violence in tandem; however, girls who reported being victims of sexual violence also reported physical violence. This shows a complex correlation but not causality.

-          In the countries where data was available physical violence against boys (15-19) outweighed both sexual violence against boys as well as sexual and physical violence against boys combined.

-          The report indicates that victims of childhood sexual abuse delay in disclosing their victimisation, if they ever disclose at all. The reasons for this delayed, or lack, of disclosure includes fear of reprisals, feels of guilt and/or shame, lack of confidence and lack of awareness of support services available to them.

-          The report indicates that in some countries girls (15 – 19) are less likely to seek help and support than adult women, with boys and men seeking less help across the board than girls or women.

-          In respect to online sexual victimisation the report indicates that children are continuing to become more internet savvy, that children feel more comfortable in sharing inmate information online and feel safer online than previous generations. The report indicates that girls are more likely to be groomed online, that older children are more likely to be groomed online compared to younger children and that all children find it harder to differentiate online between “strangers” and “virtual friends”.

-          The report highlights a recent shift in terminology with many governments adopting “child abuse images” as opposed to “child pornography”.

-          The report highlights a recent increase, as reported by governments, in the volume and variety of images, recordings as well as the live streaming of child sexual abuse.

The data in this report reinforces what we already know from the academic literature and the government statistics about the prevalence as well as reporting of sexual abuse. In doing so the report reinforces that sexual abuse is a global issue and that the same types of sexual abuse problems arise globally regardless of location and/or culture. Hence, the issues surrounding child sexual abuse that we deal with on a day to day are not just western issues (albeit the specificity of them maybe) but global ones. The report comes with an additional document highlighting six strategies for action in responding to violence against children, including sexual abuse, which highlights the need for changing social norms, better education and support (for children, families and caregivers) as well as the need for better evidence based policy. These strategies are things that we can sign up to and are already doing in our own work, but what the report does is remind us that we need to be discussing these issues and sharing good practice internationally.

Kieran McCartan PhD

Friday, September 5, 2014

Got Prevention? The California Coalition Against Sexual Assault Certainly Does!

The California Coalition Against Sexual Assault (CALCASA) has a story worth telling about the power of collaboration and preventing sexual abuse. It started in 1980 when rape crisis centers from across California joined forces to create a unified voice of advocacy for survivors – the result was CALCASA, a true coalition and voice for prevention.  With a primary focus on the prevention of sexual abuse, CALCASA has three and a half decades of commitment to ending sexual violence through a multifaceted approach of prevention, intervention, education, research, advocacy and public policy. While so many rape crisis centers around the US struggle in isolation, CALCASA is an example of what can happen when the right people get together to create positive change.

I recently had the opportunity to discuss sexual abuse prevention with David Lee, M.P.H. – CALCASA’s Director of Prevention Services and a member of ATSA.  With over thirty years working within the field, David definitely understands the history, obstacles and successes within the field of sexual abuse prevention. Although his professional prevention work began in 1982, his interest in prevention started in his youth due to his mother’s involvement in the early battered women’s movement.  He described a direct impact from his mother’s work as she imparted the clear message to her sons that violence against women was an important topic and that we all needed to be part of the solution – a message and belief David has incorporated within his life and shares with others through his work with CALCASA.  David leads CALCASA’s team in providing training and technical assistance on sexual abuse prevention to rape crisis centers throughout California, while also extending  CALCASA’s influence at the national level through PreventConnect, the nation’s leading online community to advance primary prevention of sexual and domestic violence (Kaufman, 2010).

PreventConnect is truly a unique resource provided by CALCASA as it is nationally focused and an example of the strength of multi-disciplinary collaboration. Supported by the Ms. Foundation for Women and the Centers for Disease Control and Prevention (CDC), PreventConnect is an online community of people who are committed to the prevention of sexual and domestic violence, and is based on the ideology that we can all learn and share together to facilitate prevention.   PreventConnect provides guidance, support, and tools to those who provide direct services within the field of sexual abuse prevention in order to increase the skills of individuals undertaking all levels of prevention work (Smallbone, 2008).  Utilizing various forms of online media to connect people and ideas, PreventConnect explores issues and highlights efforts to:

·         Stop sexual assault and relationship violence before it starts,

·         Engage communities in preventing sexual assault and relationship violence, and

·         Build upon the strengths of the rape crisis and domestic violence movements, public health and other prevention efforts to create social change.

Working within the field of sexual abuse prevention can be difficult and isolating at times – PreventConnect provides a distinct opportunity for national collaboration, support, and guidance, all things that can benefit and strengthen the many ways in which we work towards prevention of sexual abuse. PreventConnect activities include the Power in Prevention web conference series that highlights efforts to prevent child sexual abuse, as well as web conferences, blogs, wiki, and podcasts which share the voices of those doing prevention and provide resources and research, as well as experiences, about prevention work.  Additionally, as primary prevention research is in its infancy, PreventConnect is a place to collectively discuss and learn about new strategies within a multi-disciplinary arena (CDC, 2004).  Click here for information about the PreventConnect email group.

Sexual abuse is a complex public health issue that impacts us all – individuals, communities, institutions and society as a whole (ATSA, 2014).  CALCASA and PreventConnect are strong examples of an organization dedicated to addressing sexual abuse as a public health issue, thus directing our efforts on prevention of sexual violence before it is perpetrated. As a leading example of collaboration and innovation, we can all learn from the multidisciplinary opportunities CALCASA and PreventConnect provide.

For more information about the prevention of sexual abuse, please see:

·         Sexual Violence Preventionauthored by David Lee, Lydia Guy, Brad Perry, Chad Sniffen, & Stacy Mixson

·         Sexual Violence Prevention Fact Sheet (ATSA)

·         ATSA Prevention Committee –  

Katie Gotch, MA


ATSA Fact Sheet.  Retrieved August 2014.


Centers for Disease Control and Prevention. Sexual violence prevention: beginning the dialogue.

Atlanta, GA: Centers for Disease Control and Prevention; 2004.


Kaufman, K. (2010). The prevention of sexual violence: A practitioner’s sourcebook. Holyoke, MA: NEARI Press.


Smallbone, S., Marshall, W. L., & Wortley, R. (2008). Preventing child sexual abuse: Evidence, policy and practice. Cullompton, Devon, UK: Willan Publishing.

Friday, August 29, 2014

Minority status & the perpetration of child sexual abuse

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

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

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

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

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

Kieran McCartan, PhD

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

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

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