Friday, June 24, 2016

Q & A with Steven Gillespie & Tom Squire on "An Evaluation of a Community-Based Psycho-Educational Program for Users of Child Sexual Exploitation Material”.

Gillespie, S. M., Bailey, A., Squire, T., Carey, M. L., Eldridge, H. J., & Beech, A. R. (2016). An Evaluation of a Community-Based Psycho-Educational Program for Users of Child Sexual Exploitation Material. Sexual Abuse: A Journal of Research and Treatment.

Online sexual offenders represent an increasingly large proportion of all sexual offenders. Many of these offenders receive noncustodial sentences, and there is a growing need for community-based interventions. The aim of this study was to evaluate a psycho-educational program for community dwelling users of child sexual exploitation material (CSEM). A total of 92 adult male participants completed self-report measures at pre and post. A subset of participants also completed measures after a follow-up period. Results suggested benefits across depression, anxiety, and stress; social competency, including locus of control and self-esteem; and distorted attitudes. Furthermore, these effects remained 8 to 12 weeks following program completion. Our results suggest that CSEM users are amenable to treatment in the community and that there are beneficial outcomes in affective and interpersonal functioning following psycho-education. These factors represent treatment targets for sexual offenders and are recognized risk factors for contact sexual offense recidivism.

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

SG/TS: The Lucy Faithfull Foundation has been running the Inform Plus program for nearly ten years now and we were keen to evaluate its effectiveness.  There is an increasing number of men being investigated for child sexual exploitation material (CSEM) offenses, and many of these men want to seek help. However, there are few programs available that offer such help, and limited knowledge on what kind of programs might work with this group.

What kinds of challenges did you face throughout the process?

TS: The biggest challenge was extending the programme from 10 to 11 sessions to enable participants to complete the various measures pre- and post-programme.  This required the content of some sessions to be shifted forwards or backwards by one session, and all staff, working at different sites, had to be appropriately briefed.

SG: The evaluation involved collecting data at various different sites, from ten different groups running at different times within a twelve month period. Data was also collected at three different time points (pre, post, follow-up). Typically I run experimental paradigms so this was a very different project to be involved in. Another difficulty was identifying a suitable control group, and in the end this wasn’t possible. This is one area where our work can be built upon in the future.

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

SG: While my background is purely academic, my co-authors from the LFF have a wealth of practical experience with this client group. During the writing of the report these differing perspectives complemented each other nicely. For example, it would be easy to think that over the course of the program events in the clients’ lives might naturally have started to settle down with time. However, clients might be recalled for interview, receive court dates or appear in court at the same time that they are participating in the program. Set against this background it was interesting that we found reductions in depression, anxiety and stress that might not simply reflect the passing of time.

TS: In terms of producing this article, I am utterly indebted to Steven – without his involvement I wouldn’t be writing this now.  With regard to the actual research, we had some interesting discussions about interpreting the data, and it felt productive to combine the clinical experience of staff at LFF with Steven’s academic insights. 

What do you believe to be to be the main things that you have learnt about treatment for Users of Child Sexual Exploitation Material?

SG: Intervention with low risk offenders can pose various dilemmas, including whether or not intervention will help, or even hinder, the clients. Our findings suggest that short, low intensity psycho-educational programs could prove beneficial with this kind of sample. Our results also suggest that these men are amenable to treatment in the community, which is important given that a large number of CSEM users may not go to prison.

TS: Our research lends weight to the idea that psycho-education, as part of a relatively short intervention, is an effective approach to take with CSEM-only offenders.  In addition, the research is congruent with literature about the benefits of group-based intervention and the importance of the facilitators’ style and approach.  

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

TS: We are at our best when we engage with the whole person and all their needs.  Clients must never be reduced to no more than the embodiment of risk, however that might be classified.  A philosophy of purposeful collaboration and enquiry should be our guide - our clients have much to teach us.

Steven Gillespie, Ph.D, is a Lecturer in Forensic Psychology in the School of Psychology at Newcastle University.

Tom Squire is Clinical Manager at the Lucy Faithfull Foundation.

Friday, June 17, 2016

Alcohol, Vulnerability, and Sex = Rape

“Some people see vulnerability and become exploitive;
others see vulnerability and become protective.  This story saw both.”

On January 17, 2015, Stanford freshman Brock Turner and a young woman both ended up at a college frat party.  The next morning he was in jail, she was in the hospital, and they were both trying to figure out what happened.  This was not the alcohol-infused sexual encounter between consenting young adults, which happens with tragic frequency.   They were both drunk, but didn’t know each other.  There are no crisp laws for when blood alcohol content (BAC) is too high for someone to consent to sex, so let’s agree that when at least one party has reached the not-so-scientific threshold of ‘shitfaced,’ they should not engage in sex.  The limit of BAC to legally drive a car provides a reference point for intoxication.  It’s likely that, at least mechanically, having sex is less complicated than operating a motor vehicle, but in this case, Turner’s BAC was twice the legal limit for driving; her BAC was three times.  Without testing, how can one know if potential sexual partners are shitfaced?   A clue might be when one individual has passed out.

To avoid further victimization, the media has protected her identity, but to try to elevate her above the label of ‘victim’ or a simple pronoun, I’ll offer the small dignity of a capitalized ‘She.’

Sexual abuse is epidemic in the US and pervasive on college campuses; so why did this story catch international attention?  In part because of some classic themes that illustrate disparities in our criminal justice system: the offender was white, attending a prestigious college on an athletic scholarship, and he came from a family of means that afforded him a top legal defense.  But what truly propelled this story into viral status were three other factors: the extraordinary intervention of bystanders, an amazing victim impact statement, and unexpected leniency in sentencing.

When it comes to interpersonal sex, there must be no confusion about consent; but when alcohol is present, consent is always muddied.  Alcohol is not an excuse for rape; it just happens to be a contributing factor in half of all rapes, particularly on college campuses.  When so much about sex happens under the ‘control’ of primitive parts of the brain, it would seem people cannot afford to have any impairment to executive functioning.  An expert at trial testified that one does not have to be unconscious to not remember having sex; they need only be drunk enough to experience a blackout.  This impaired state can facilitate an illusion of consent – with tragic outcomes for both parties.

If She was functioning in a blackout when the sexual encounter began, She was unmistakably unconscious when the sexual assault was interrupted by Stanford graduate students Peter Jonsson and Carl Fredrik Arndt.  As they were riding their bicycles near the frat house at 1 am, they might have ignored two people having sex outside on a Saturday night, but the location by a dumpster seemed odd and when the woman appeared unresponsive, they confronted Turner, who ran.  While Arndt checked on the victim, Jonsson gave chase, tackled Turner, and held him until police arrived.    Some people see vulnerability and become exploitive; others see vulnerability and become protective.  This story saw both.

This contrasting response to vulnerability illustrates curious questions about the flaws and virtues that are ubiquitous in human nature – and typically even found within the same individual.  One treatment target for those who have sexually offended is empathy building.  But a question remains: if when exposed to vulnerability, one is not instinctively protective, can one learn to be protective, or at least not exploitive?  How innate or malleable is this potent, if sometimes unfortunate human characteristic?  

An equally compelling takeaway from this story is how some victims become survivors while others remain victims.  Whether She had the resiliency to tell her story, or found resiliency by telling her story, She undoubtedly has inspired an untold number of victims of sexual abuse to come forward, ask for help, and seek justice.   The world won’t know her name, but millions of people will remember that She wrote a powerful, unfiltered narrative of her journey – from gradually discovering being sexually violated, to enduring the trial of her assailant.  Her full (7,200 word) victim impact statement can be found on the Internet.  There is an edited narrative of her poignant story on YouTube.  Her evocative words drew a heart-felt response from US Vice President Joe Biden.  While the Internet facilitated millions to read her poignant reflections, the Internet will also never forget what Brock Turner did.  His life is in tatters.

A jury found Turner guilty on three felony counts.  He was eligible for 14 years in prisons, prosecutors asked for six years, probation recommended four to six months in county jail.  Turner was sentenced to six months in jail (less with good behavior).  Prison sentences are expected to strike an equitable balance between public safety, punishment, and rehabilitation.  However, by international standards, the US is a leader in both the use of prisons for punishment, and in the length of prison sentences.  Public opinion might be divided on where this sexual assault falls on the heinous scale, but overwhelming public opinion is that six months in jail was a miscarriage of justice. 

Judge Aaron Persky’s effort to spare Turner the “severe impact” of a long prison sentence may have been well intended but might have ultimately backfired.  It fueled an impeachment petition against the judge and probably aggravated public backlash against Turner.  If Turner can avoid rape or assault while incarcerated, any jail time might be the least impactful of the life-changing consequences of his offense.  He is now a convicted felon, subject to lifetime registration as a sex offender, he forfeited a prestigious education, his aspirations for being a world class competitive swimmer are shattered, and any glorious career ambitions are all but over.  Sometimes people can be held accountable for personal violations, outside of the criminal justice system, and without long prison terms.

Sexual assaults and binge drinking on college campuses are rampant.  Reported rapes on college campuses are a fraction of all sexual violations between students.  Some college students are falsely accused of rape, and in one high-profile case the entire Duke Lacrosse Team paid a high price for false allegations.  When so much is at stake for young women and men, we can’t afford to get this wrong.  It’s a bit ironic that college campuses, with their vast educational resources, have not been more effective at reducing the prevalence of sexual violations between students.

According to recent reports, Peter Jonsson and Carl Fredrik Arndt have yet to meet the woman who they rescued.  But She wrote that, “I sleep with two bicycles that I drew taped above my bed to remind myself there are heroes in this story.  That we are looking out for one another.”  Hopefully this compelling story will inspire other bystanders.  Perhaps we will make real progress when we truly understand that justice is neither served when victims remain shamefully silent, nor when offenders can never recover.  Neither victims nor offenders want to be forever remembered for the most regrettable times of their lives.
Jon Brandt, MSW, LICSW
When will our consciences grow so tender that we will act to prevent human misery rather than avenge it?”   Eleanor Roosevelt, February 16, 1946

Friday, June 10, 2016

The Lifelong Damage Labels Carry

Juvenile sex offender — the term abounds in courtrooms, headlines and even among professional treatment and welfare circles. In five syllables, kids go from curious 8-year-olds and teenagers hopped up on hormones to social deviants. It is misguided to define any human by a single action, but when we refer to children as sex offenders the consequences are particularly destructive.

In the United States, federal law mandates that minors adjudicated for sexual offenses be subjected, alongside adults, to “sex-offender” registration and notification requirements. Numerous studies over several decades now have definitely confirmed registration does not deter first time offenses or reduce recidivism — in any instance. Public health officials found in a study published last year that rather than improving public safety, this practice, “communicates constantly and in a variety of ways that [registered] youth are dangerous, feared, worthless and have no real future.”

After leaving my job as a juvenile public defender almost a decade ago, I spent years traveling the country to interview people who had gone on registries for things they did as kids, from playing doctor, streaking or Romeo and Juliet romances to committing serious sexual harm. I sat in their living rooms, with their parents and children of their own, as they described what it’s like to go through the world as “juvenile sex offenders.” They had been physically assaulted, fired from jobs, driven out of schools. One young man I met with would later tell a reporter that I was the first person who told him he wasn’t a sex offender. He’d been on the registry for almost half of his life at that point.

Intended or not, the term sex offender invokes a visceral response in the public. Meanwhile, just the word offender implies that the person intentionally caused harm and offended more than once. Many of these kids were themselves victims of abuse and didn’t even know at the time what they’d done was wrong. And empirical research shows the vast majority — more than 97 percent — have never and will never reoffend sexually.

Even using the term sex-offender treatment is harmful. By framing it as “sex-offender treatment,” we overlook that when it comes to kids their behavior has very little to do with sexual pathologies. Beside, we don’t dismiss people with other psychological symptoms, such as depression or anger, with a single noun; and we shouldn’t in this instance either. In a new study to be published later this year, public health officials surveyed more than 220 kids in treatment for sexually intrusive or abusive behavior. Compared to those who have never been subjected to registration, youth who currently or have previously had to register as a sex offender report significantly higher rates of considering and/or attempting suicide.

As the director of the Center on Youth Registration Reform, my work focuses on youth, my goal is to eliminate the practice of putting minors on registries; but to do that we have to challenge the public narrative around youth sexual behavior. That starts with being more deliberate in conversations on this issue and not using the term sex offender to describe children — under any circumstance. (I normally try to avoid the term sex offender altogether, but I’ve left it in this article so readers can see just how often it creeps in.)

Researcher Sharon Denniston’s recent doctoral dissertation measured the impact juvenile registration has on adult depression. She found that it’s not the legally imposed restrictions but rather the sex-offender label that often has the greatest psychological impact. Interestingly, those on non-public registries suffer from even higher depression rates than those on public registries, which suggests how deeply youth internalize being branded.

In the media, headlines teem: “New therapy proves effective for juvenile sex offenders,” “States Slowly Scale Back Juvenile Sex Offender Registries,” “Are We Properly Dealing with Young Sex Offenders?” What we should be asking is whether we’re properly educating youngsters about sexual boundaries, whether we’re giving child sex abuse survivors the resources they need to heal and whether we’re doing permanent damage because we’re too lazy to say a few extra prepositions. Childhood is about second chances. When we label kids we rob them of identity — and, even worse, hope. We make it is easy for society to demonize and treat them as other.

Moving forward, we must be more vigilant of the words we choose, always careful not to reduce a person to an action or a nuanced behavior to a simplified pathology. And the change must start with us — treatment providers, child welfare experts and juvenile justice professionals. As a body we must pressure the media to reconsider how it uses the term sex offender; if the public discourse can be redirected, eventually sentiments will begin to shift as well. And maybe then we will be able to see our children for what they really are: children.

Nicole Pittman, esq., Director of the Center for Youth Registration Reform at Impact Justice, has been working to remove kids from registries for more than a decade, through legislation, law and creating awareness. Also a juvenile attorney, she is a Stoneleigh and Rosenberg Leading Edge fellow.