Thursday, August 27, 2015

Q & A with Gerald Zeng co-author of "Risk and Criminogenic Needs of Youth Who Sexually Offended in Singapore: An Examination of Two Typologies"


Zeng, G., Chu, C. M., Koh, L. L., & Teoh, J. (2015). Risk and Criminogenic Needs of Youth Who Sexually Offended in Singapore: An Examination of Two Typologies. Sexual Abuse: Journal of Research and Treatment.

http://m.sax.sagepub.com/content/early/2015/05/22/1079063213520044.abstract?sid=a9c885c4-62ae-42a1-afa5-6de107fbaf44

An increasing amount of research has been carried out to understand the characteristics of subgroups of adult sex offenders, but there is limited research into the risk factors and criminogenic needs of subgroups of youth who sexually offended. The current study investigated if there were differences in the risk and criminogenic needs of 167 Singaporean youth who sexually offended based on two typologies - youth who offended both sexually and nonsexually versus youth who offended only sexually, and youth who offended against child victims versus youth who offended against nonchild victims. Results show that youth who offended both sexually and nonsexually were found to have higher risk and criminogenic needs as compared to youth who only sexually offended. In addition, youth who offended against child victims were found to have higher numbers of previous sexual assaults as compared to youth who offended against nonchild victims. These differences have implications for the management and intervention of youth who sexually offended.


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

The aim of the study was an exploration of the differences between two typologies of youth sexual offenders which have been previously examined in the Western context. We wanted to see if this was similar locally (Singapore) for youths who had sexually offended. A lot of information that we have on youth offending in Singapore is from research conducted in the Western context, and we are seeking to build local research expertise and findings to better inform our clinical and forensic interventions.

What kinds of challenges did you face throughout the process?

The primary challenge for us was in data collection, which had to be co-ordinated among five coders. Training and resolving differences in understanding the way in which the ERASOR and YLS/CMI were coded was particularly challenging. The coders were a mix of researchers and clinicians and obtaining consensus took some amount of discussion and debate, even with the very specific manuals provided for both instruments.

We were also challenged by our reviewers who asked very pertinent questions that allowed us to not only strengthen our paper, but also broaden our understanding and perspective on conducting research in youth sexual offending.

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

The research centre that Chi Meng (second author) and I work in, the Centre for Research on Rehabilitation and Protection, was established as a centre of excellence in research and practice development. We work closely with operational and clinical staff, such as from the Clinical and Forensic Psychology Service, where both Jennifer and Li Lian (the other co-authors) are from. All three of my co-authors are clinical and/or forensic psychologists, with many years of experience practicing in the field.

A huge benefit from working in the public service with scientist-practitioners such as them, is that I personally learnt a lot about translating research data and findings into policy and practice. Through that, I was exposed to different ways of thought about forensic work and assessment. This has subsequently fed into the way studies are currently designed, executed, analysed and interpreted.

What do you believe to be to be the main things that you have learnt about juvenile sexual offending in Singapore? Also what differences, if any, was found in respect to western research in this area?

One point of difference that we found between our local and Western research is that only a small minority (about a third) of our youth committed both sexual and nonsexual offending. This is a much lower rate as compared to other Western studies (up to 60%-90%), and suggests that the majority of local youth who sexually offended may indeed have a different set of risks and needs as compared to their Western counterparts; further studies will have to be carried out though, to explore if such differences exist.


Thursday, August 20, 2015

Big World, Similar Issues


I have been spending sometime recently at Griffith University as a visiting scholar at the Griffith Criminology Institute as part of an international network; this trip has provided me with some great insights into Australian sexual harm management practices. On Wednesday we had a conference on community engagement and sex offender management where a number of issues where discussed including Circles of Support and Accountability (myself), sex offender registration (Professor Andrew Day, Deakin University), working with Aboriginal Communities (Professor Stephen Smallbone, Griffith University), desistence from sexual offending (Dr Danielle Harris, San Jose State University) and how to engage with the community on issues of sexual abuse (myself). What really stuck me was that the issues that we all face are the same regardless of geographic location (whether it is North America, Canada, Australia, UK or Ireland to name a few locations) only the context is slightly different. I am not sure whether this is a good or a bad thing? On one hand it’s reassuring to know that our issues are the same and that the majority of problems that we face in the sexual harm field are not that different, while on the other hand it’s depressing to know that all the problems are the same and therefore we start to question whether we are making any head way.

What are some of these issues,

-          There is a separation between research, evidence and policy with much sexual harm policy being reactionary and based on ideology not research. So more “policy based evidence” (“Quick we have made a policy quick find some evidence to justify it”) rather than “evidence based policy” (“listen we need to develop a new policy let’s do some research and get some evidence first”).

-          There is often a disagreement between professionals about whether treatment with sexual offenders works, whether it should be supported or whether it is simply a tick box exercise to indicate that something is being done with this difficult and challenging population.

-          There is often a gap between the state and government’s perception of how perpetrators of sexual harm should be responded to in comparison to researchers and/or treatment providers. The state/governments response is usually harsher, more restrictive and less engaged.

-          There are similar laws and a desire to good down similar policy paths. Registration and disclosure is a good example with Australia having a sex offenders register, similar to the UK, USA as well as other international countries, and now based on a high profile case (Daniel Morcombe) some areas of Australia have community notification with other areas looking into it.

-          That some tools for working with sexual offenders are becoming more and more global including Circles of Support and Accountability, which is being trialed.

-          Reaching and doing community and public engagement can be difficult and challenging because of the way that perpetrators of sexual harm are viewed by the community. With community members (recognizing that there are multiple publics and that all members of the community are not the same and do not think alike) believing that all “sex offenders” are the same, won’t change and should go to prison for extended periods.

-          Different cultures within the same country can be more difficult and challenging to reach than others. I felt that there was real resonance with some of the issues facing professionals trying to work with Black and Ethnic Minority groups in the UK (especially in the light of Rotherham)  and the challenges presented by working with aboriginal and/or remote communities in Australia on these issues. The difficult line between education, safeguarding, management and cultural sensitivity.

-          The issue of historical cases of child sexual abuse and sexual harm committed within state institutions; Australia, like the UK, also has a commission investigating these cases.

-          The understanding, especially among professionals, that not all perpetrators of sexual harm are specialists, that the majority of them are generalists and that we need to look at their anti-social, dysfunction lifestyles as much as we look at their offending.

-          That the state and criminal justice system is interested in people who commit sexual in as much as they are interested in preventing recidivism and risk managing them; but, that they may not be as interested in helping them to develop pro-social, positive lifestyles and to fully integrate into society.

-          That we need to go a lot further in the way that we think about sexual harm prevention, that we need to get the message out there more and that it needs to be ingrained in schools, clubs, societies more. There is a recognition that the messages need to be process and not outcome driven, as well as that the need to be more societally focused (less individualized) and more proactive (rather than reactive “how to avoid being a victim…”).

These issues are common, international and recurring. Although, it may seem disheartening at first, which it is because we have got a long way to go, it does offer some hope because are all dealing with the same issues and therefore in sharing good practice, good research and good policy we can overcome this issues together.

Kieran McCartan, Ph.D.

 

Friday, August 14, 2015

100 difficult conversations talking prevention with Dan Knoepfler

Washington State has a history of cooperation between those who do victim services and those who treat sex offenders.  There has not been  the all too common “us versus them” mentality. However, what Dan Knoepfler noticed over his nearly 30 years of working with youth and adults who’ve sexually acted out is that it has been  a bit one sided. Groups like King County Sexual Assault Resource Center (KCSARC), Washington State Coalition of Sexual Assault Programs (WSCAP) and Harborview Center for Sexual Assault and Traumatic Stress (HCSATS) consistently and actively spoke out against problematic policies related to those who caused harm and supported productive policies that local ATSA/WATSA  folks advocated for.  Local victim advocate and prevention leaders such as Mary Ellen Stone and Lucy Berliner understand and have spoken out about stopping an abuser from offending as being an effective prevention strategy as well as doing their work with potential victims.  While they didn’t want to coddle the men who abuse others, they understood the importance of helping men obtain stable housing and having a way to be self-supporting so they are less likely to re-offend and not be a drain on the system.

While supportive of victim services and their prevention efforts, it was only when the funding for such services was in jeopardy that Dan realized that he and others working on his side of the coin hadn’t been as active in speaking up in the support of the needs of those who do work for victims and prevention as they had been for his and other ATSA/WATSA members’ work. 

Dan was keenly aware because he was raised by activist parents, who were also trained sex educators no less. For many years his office was decorated with a bumper sticker that said “Silence = Complicity.”  It was a message for his clients but also something he believed in.  When Dan attended a fundraising breakfast for victim services/prevention groups sponsored by KCSARC he was inspired by the voices of victim/survivors and the groups slogan “Be-Loud.”    Dan had the uncomfortable realization that he hadn’t been practicing what he believed in and it was time to look in the mirror. He realized he had been silent and therefore complicit in the lack of support for these services he believed in and who had stood up for his work.  He committed to have a far more active role.
Dan set a goal of having 100 Conversations this year about the importance of victim services and prevention.  How? He put is two slogans together and made a t-shirt that was a conversation starter. He invested in a banner to show his support for the agencies. Every time he speaks he brings the banner, explains the importance of the services and their need for support and gets people to sign it. He wears his t-shirt everywhere and when it got a bit worn he added a new one - “Consent is Sexy.”  This   is a message he uses to teach his clients, but it is also much more.  Particularly on the body of a passionate, funny and vocal advocate for a deeper understanding of what Dan refers to as “going beyond ‘yes means yes,’ which is definitely better than ‘no means no.’  He teaches that consent is a multi-dimensional, multi-faceted, time-limited, and situational concept.   Dan’s “Consent is Sexy” t-shirt has been a catalyst for continued action.  Sometimes, Dan accessorizes his t-shirt with a “Be Loud” button.  How is that for a fashion statement?

Potentially damaging policies can also be a catalyst to action.  One example was when Washington’s legislature was seriously considering community notification of every juvenile convicted of a sexual offense.  The intent of the bill was to send a flyer home to every parent at that student’s school.   Dan knew he had to be visible in his opposition. He knew he needed to do that 60 mile drive from Seattle to Olympia to testify. He knew that if it passed, it would take years to change it and even longer to undo the harm to the kids he works with on a daily basis. Yet when he spoke up against it at a gathering at his local library near his office, he was accused of being a sex offender himself and run out of the meeting. Ultimately, with many working together, the bill was defeated (several years in a row). While Dan believes in speaking out, he recognizes the risk and advises all to consider their own safety.

In terms of the success of the conversations Dan has everywhere he goes given his t-shirts, buttons and banner, he believes we have a ways to go to get the general public to recognize the value of preventing initial perpetration. Dan’s biggest success has been with his colleagues.  He has worked to get others who assess, manage and treat those with problematic sexual behaviors to recognize their role in prevention and the importance of speaking out themselves and in support of victim and prevention services.

Dan is the spark for 100 conversations to encourage people that might otherwise be complicit in their silence to speak out and to see the power and possibilities of consent. Through Dan’s actions, he is helping us to see actions we can take.

Dan Knoepfler, MC, LMHC, is an ATSA member who nearly 30 years has done assessments and treatment with youth and adults who’ve sexually acted out.

Interview and blog by ATSA-Prevention Committee Member: Cordelia Anderson, M.A. has been working to prevent child sexual abuse, exploitation and sexual violence since 1976. She is a member of the ATSA Prevention Committee


Friday, August 7, 2015

Five Questions Regarding the Polygraph


Introduction

The use of polygraph examinations has again captured the attentions of ATSA’s listserv in recent days, albeit with some interesting twists. Historically, debates have centered on balancing the right against client self-incrimination versus the seemingly valuable information it provides. There remain the scientific elements of validity and reliability, with adherents of each perspective believing that the science touted by those with other perspectives is flawed. During this discussion, however, it has been noteworthy that participants who live in areas of the US where the polygraph is used most extensively have come to question its use, especially with juveniles. Are times changing?

1)      The backdrop: Where does the polygraph fit into the treatment of traumatized and otherwise vulnerable clients?

The recent ATSA listserv discussion began with a request for research that would inform whether it is appropriate to use the polygraph with an 11-year-old. The average response, including from those who use the polygraph routinely, was no. It is interesting to recall a study by Craig and Molder in 2003, who polygraph examiners in law enforcement and found that while many expressed concern with its use with those under 12, the majority of examiners made no modifications to their practice when testing juveniles.

To the present, no one has published a study that seeks to clarify peoples’ experiences with these examinations. This seems important. For instance, research has shown that adolescents involved in the legal system often present with a startling array of trauma histories, brain injuries, and other mental health issues. Recent trends in juvenile justice have emphasized trauma-informed systems of care, and the importance of trauma-informed care is beginning to catch on in the adult world as well. Where does the polygraph fit into trauma-informed care?

Although it is easy to see sex offenders, particularly in prison environments, as hardened individuals, it is easy to overlook their vulnerabilities. Jill Levenson, Gwenda Willis, & the author have recently published two studies of the rates of childhood adversity in adult male and female sex offenders. James Reavis, Jan Looman, and their colleagues published a similar paper, asking the important question, “How long must we live before we possess our own lives?” Many, especially those working in prison environments, have noticed that their clients in sex-offender treatment do not present as highly vulnerable, shrinking violets. On the other hand, there is a question of whether the wrong treatment approach (which might involve the polygraph) with the wrong client might actually exacerbate the trauma-related cognitive schemas (e.g., dangerous world, negativity) that therapists are attempting to redirect in treatment. 

A case in point might be the 23-year-old client with a mild autism spectrum disorder. Socially isolated and awkward, he views the world as a dangerous and threatening place where the closest he will ever come to rewarding relationships is through contact with children. Depending on how he views his treatment team, a polygraph examination under the wrong conditions might well reinforce his core beliefs that he will never fit in anywhere and might just as well persist in trying to have close relationships exclusively with children. On the other hand, treatment aimed at improving his interpersonal competence at the same time as allowing him the chance to develop and rehearse his skills at managing risk factors may be more beneficial. 

Of course, a final consideration is that the polygraph is not necessarily verifying ground truth. The research is full of studies regarding the problems of false confessions and the fallibility of memory.  The author is one of many professionals who have had clients make false confessions hoping that it would speed their treatment progress. The teachable moment of these experiences is to establish a treatment culture in which honesty and commitment are valued more than the appearance of compliance with expectations.

2)      What are we trying to change in treatment?

The trauma-related points may seem small to many, but are important to consider. In the case example above, it may be that treatment is more effective, particularly in an era of scant resources, when it focuses on the development of skills rather than on preparing for an examination that will provide the impression that a client has become more honest. Is it possible that one-size-fits-all approaches to the polygraph can actually make matters worse by focusing on less relevant areas and slowing the pace of treatment for some in institutions where treatment slots are in short supply? What level of disclosure is good enough for treatment to be effective?

In a fascinating study, Shamai and Buchbinder explored the client perceptions of a treatment program for violent men. From the abstract: “The findings revealed that most of the men experienced therapy as positive and meaningful and underwent personal changes, especially the acquisition of self-control. Deeper analysis of the data, however, shows that the men still used a power scheme in understanding and creating relationships with others, especially with their woman partner.”  In other words, the program produced some changes, but left the underlying structure of their relationships untouched. Further, the authors found that in many ways the program modeled the same power dynamics they were seeking to change. Is it possible that in some cases our programs, by coercing confessions, are modeling the same dynamics of power and control that we are seeking to change in our clients?

Even beyond these considerations, questions and controversies abound. The author published an article on the polygraph with juveniles in 2012 for the ATSA Forum newsletter that made points that are relevant to the treatment of adults as well. These include that more information is not necessarily better information and that compelling disclosure is not necessarily the same as building the capacity for honesty.

Since that article’s publication, Roger Cook, one of the authors cited in it has produced an interesting study with his colleagues that points to many of the complexities involved in polygraph with adults. Sadly, there has been only one recent study with juveniles.  It examined the information gleaned through the use of polygraph with juveniles.  In it, juveniles reported sexual abuse of an average of 1.42 people. After a polygraph examination process, they reported sexual abuse of 2.15 people, or roughly 2/3 of an additional person abused. Given the legal and psychological complexities at stake, there is a real question of to what extent this really is helpful information. Some believe they couldn’t do their work without the polygraph. Others state quite clearly that their clients in treatment are honest enough that they are able to make acceptable changes to their lives such that sexual abuse becomes unnecessary and undesirable to them at all times. Perhaps professionals should consider soliciting feedback from their clients to assess whether the process as well as the content of polygraph exams is more helpful or intimidating. Of course, such an endeavor requires first ensuring an adequate culture of feedback. Further, it is likely that there is a great deal of variability between polygraph examiners in terms of how their examinees perceive them (the same is true of therapists).

3)      How are we trying to change our clients?

It’s worth mentioning briefly that research has shown that the most effective therapists in our field and in related fields are warm, empathic, rewarding and directive. Karen Parhar and her colleagues noted that the more coercive the treatment experience (and there are gradations of coercion), the less like treatment is to be effective. What can treatment programs employing polygraph learn from these findings? How does the polygraph fit in? How might the behaviors of individual polygraph examiners play a role in treatment outcome?

4)      What are some of the broader questions we should consider?

Of course, all of these issues beg even larger questions; let’s broaden the discussion. In 2004, Andrew Harris and Karl Hanson, describing a long-term recidivism study involving 4,724 adult sex offenders, observed that:

After 15 years, 73% of sexual offenders had not been charged with, or convicted of, another sexual offence. The sample was sufficiently large that very strong contradictory evidence is necessary to substantially change these recidivism estimates.

The numbers for juveniles are arguably even more encouraging. Although official records are likely underestimates of the true rate of re-offense, what seems clear is that simply being processed through the legal system goes a long way to preventing future abuse. Other studies have found that re-offense is reduced by around 40% for those who complete treatment programs, including those that don’t use polygraph.

Based on this, perhaps professionals should reconsider using the polygraph as a standardized component of treatment programs, consider the potential downside impacts, consider under what conditions it may become an advisable component of treatment (if at all), and devise individualized plans for the specific circumstances under which they will use it. 

5)      So how do people change, anyway?

Maybe it’s time to ask what we know about how people actually make longstanding changes to their lives. After all, we already have strong evidence regarding the principles of effective correctional treatment and the components of effective treatment goals. Tying these threads together, you might want to ask yourself: Have you ever made a big change to your life? Did you make that change with the help of a therapist? If so, did you need to disclose each time you had engaged in behaviors related to the change you were making? Would you have done so completely and honestly if your therapist said it was vital to accurate diagnosis and treatment? In order to make that change, was it more helpful to review the details of the past, or to make an outline of how you wanted to live your life. In other words, what was the active ingredient in making and sustaining this change?

Another way of thinking about this is to recall that other forms of treatment don’t require full disclosure in order to improve functioning. Addicts needn’t disclose every time they took drugs or alcohol, people with eating disorders don’t need to disclose each instance of binging and/or purging, and although some might think these are imperfect analogies, it is also true that violent men don’t need to disclose each instance of violence in order to adopt a non-violent lifestyle.

Clearly, the above are bold statements, and yet I make them with the intention of asking what is actually necessary to build healthier lives and safe communities. To what extent do we professionals require full disclosure to meet our own needs for certainty? Have we ever asked those who have been harmed by abuse whether they want full disclosure of past acts or simply enough of an honest discussion that they can make meaningful amends and build a safer future? If there is anything to be learned from working with people who have been sexually abused, it’s that they need to be able to disclose and heal from their abuse in their own time and in their own way. Even in trauma work, there is little evidence that one needs to disclose what happened in order to move forward with one’s life.  Indeed there is some recent evidence that recalling every transgression might be counter-therapeutic.

There will doubtless be more controversies and more research involving the polygraph. As the field sorts through these issues, perhaps we can all consider whether we have adopted an as-yet empirically unsupported paradigm regarding the importance of complete confession, and whether we are having trouble separating our values from our knowledge about what actually works. Those who provide treatment without the polygraph often come to view disclosure as an ongoing process and not necessarily an event.

Ultimately, by adopting a full-disclosure paradigm based more on values than research, and despite the myriad problems of confession, false confession, and memory problems, even when our clients themselves can be highly vulnerable, one has to wonder; have we created mindsets from which we cannot escape?

Conclusion

Obviously, having clients willingly disclose the entirety of their past offending makes the therapist’s work easier. However, it seems worth exploring whether holding back people in treatment who really do want to build better lives for themselves because they can’t pass a polygraph exam is really worth the financial and other human costs. Whose needs are we ultimately meeting?  What goals are we trying to achieve?  And what steps can we take to ensure that our interventions do not themselves cause harm?


 David S. Prescott, LICSW

Sunday, August 2, 2015

Q & A with Jesse Cale author of "Offense Trajectories, the Unfolding of Sexual and Non-Sexual Criminal Activity, and Sex Offense Characteristics of Adolescent Sex Offenders"

Cale, J., Smallbone, S., Rayment-McHugh, S., & Dowling, C. (2015). Offense Trajectories, the Unfolding of Sexual and Non-Sexual Criminal Activity, and Sex Offense Characteristics of Adolescent Sex Offenders. Sexual Abuse: A journal of Research and Treatment.


Abstract
The current study examines offending trajectories of adolescent sexual offenders (ASOs). Until recently, classification frameworks have not been designed to account for the heterogeneity of offending patterns in adolescence, how these are associated with the unfolding of sexual and non-sexual criminal activity, and whether and to what extent they are related to the characteristics of sex offenses in adolescence. The current study takes a longitudinal view of offending in adolescence by examining retrospective longitudinal data of 217 ASOs referred for treatment to a clinical service between 2001 and 2009 in Australia. General offending trajectories in adolescence were examined using semi-parametric group-based modeling, and compared according to non-violent non-sexual, violent-non-sexual, and sex offending criminal activity parameters (e.g., participation, onset, frequency, specialization/versatility) and the characteristics of the referral sexual offense. The results show distinct differences in the unfolding of sexual and non-sexual criminal activity along different offending trajectories of ASOs, and further, that these trajectories were differentially associated with the characteristics of the sexual offenses they committed.

Could you talk us through where the idea for the research came from?
After completing my PhD in criminology in Canada, I pursued a Post Doc working as a research fellow in a clinic that delivers treatment for Juvenile Sex Offenders in Australia. During my time there I worked very closely with the clinicians on several projects. In the office, over lunches, etc., I found it fascinating to speak with clinicians who have been working with specific clients over time. Not surprisingly, they have very detailed knowledge of their life histories and circumstances and behaviours. Two things stuck in my mind, the first was: where these youth begin, and where they end up (i.e, in the criminal justice system), and the basis for what they do, is overwhelmingly complex. The second, was that over the years I worked with the clinicians, I kept hearing similar stories, not identical but similar. I wanted to find a way to articulate the complexity of these youths’ pathways over time. In effect, I wanted to find an effective way to translate clinical impressions into empirical evidence.

What kinds of challenges did you face throughout the process?
Really it was such an amazing process of discovery. Being in a clinic where you can bounce ideas off clinicians on a day-to-day basis was a crucial dimension of the process. I think one of the biggest challenges was learning the main methodological technique used in this study which took considerable time. In addition, while working in a clinical setting as a researcher was a very enriching experience, the other thing I realized was just how much clinicians have on their plates in terms of caseloads and management. So it definitely was challenging to coordinate schedules.

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

Through this experience more broadly, I think the biggest take-away for me was that integrating clinicians and researchers in these settings to a much greater extent is the way forward to produce the highest quality of research in the field. This is not to say this does not happen, but clinicians and researchers bring unique perspectives, skills and experience to bear on the problem. Skilled researchers provide context to clinical observations and can also help to make clinical data viable for high quality research if they are involved from the ‘data-collection’ stage. On the other hand, clinicians can make enormous contributions to inform research directions and make meaning of data.    

What do you believe to be to be the main things that you have learnt about juvenile sexual offending based upon your research?
I think that there are a few key things I have learned from the research. From a methodological point of view is the importance and benefit to using repeated measurements over time to understand offending/behaviour. I think the main discovery this allowed for was to see that different types of sex offences are uniquely embedded in offending trajectories that are characterized by different crime types and offending patterns. In other words, individual offending patterns are related to the nature/characteristics of specific sex offences, and here we have identified quite specific offending patterns. Again, this really speaks to the complexity, but I don’t see a way around it, behaviour is inherently complex!

Now that you’ve published the article, what are some implications for practitioners?
I think the main practical take-away is a framework to: a) explore how individual differences and risk factors are related to individual offending patterns; and, b) provide insight into the onset and nature of sexual offenses committed by youth. The utility from a clinical perspective is tailoring innovative and individualized treatment strategies based on an understanding of how sexual and non-sexual criminal activity are related to each other and unfold over time.