Vol. XXX, No. 4
Fall 2018
Text Only Version
In This Issue
Regular Features
Editor's Note
President's Message
Is there such thing as “sexual harm” or is it always Abuse or Trauma?
Featured Articles
Moving beyond the “sex offender” dialogue:
How ATSA members can promote person-first language
Pros and Cons of Manualized Approaches to Sexual Abuse Specific Treatment:
Experiences of Programs in Kansas & Oregon
The Clinical Practice Corner: Juvenile Practice
The ATSA Adult Clinical Practice Committee
Students' Voice
The ATSA Student Experience:
A Personal Anecdote on Attending the Conference and Joining the Student Committee
Book Reviews
Two by Jeglic and Calkins
The Safer Society
Handbook of Assessment and Treatment of Adolescents Who Have Sexually Offended
2018 ATSA Conference Events
Public Engagement Event
Welcome Incoming Board Members
2018 ATSA Awards
New ATSA Members
Newsletter Tools
Search Past Issues
Print-Friendly Issue
Print-Friendly Article
Forum Team
David Prescott
Book Review Editor

Sarah Gorter
Production Editor

Forum Editor
Contact the editor or submit articles to:

Heather M. Moulden, Ph.D.
Forensic Program
St. Joseph's Healthcare
Hamilton, Ontario, Canada
E: hmoulden@stjoes.ca
P: (905) 522-1155 ext. 35539
Featured Articles
Moving beyond the “sex offender” dialogue:
How ATSA members can promote person-first language
Gwenda M. Willis
School of Psychology, University of Auckland
Elizabeth J. Letourneau
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University


Gwenda M. Willis

Elizabeth J. Letourneau

Author Note

Gwenda M. Willis, School of Psychology, University of Auckland.

            Correspondence concerning this article should be addressed to Gwenda M. Willis, School of Psychology, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.


ORCID ID: orcid.org/0000-0001-9827-3397

There is growing recognition that individuals convicted of sex crimes can and do desist from sexual offending (Caldwell, 2016; Hanson, Harris, Helmus, & Thornton, 2014; Hanson, Harris, Letourneau, Helmus, & Thornton, 2018), that people with sexual interest in children often desire help to avoid acting on their attractions (Beier et al., 2009) and that sexual abuse perpetration is preventable (Letourneau, Eaton, Bass, Berlin, & Moore, 2014).  It would seem that to some extent, professionals and (to a lesser degree) the public are moving away from viewing everyone who has engaged in harmful or illegal sexual behavior and/or who has sexual interest in children as presenting a high risk of offending.  That is, we are slowly shifting away from viewing people who have or might sexually offend as “monsters”.  Yet the labels we use in our professional work may align more closely with the “monster” label than with a humanistic and prevention-oriented approach.  Many professionals, organizations and scholarly publications continue to label and define the people at the center of their work based on their behavior or attractions (e.g., “sex offender,” “abuser” “pedophile”[1]).  ATSA, like its sister organizations NOTA and IATSO, is no exception, using the “Abuser” label in its name.  Similarly, labels appear in the titles and content of several books currently in circulation for treatment providers (e.g., Carich & Musack, 2015; Prescott, 2009; Sawyer & Jennings, 2016; Yates, Prescott, & Ward, 2010), many treatment program names (e.g., “Sex Offender Treatment Program” or “SOTP”) and in clinicians’ and evaluators’ everyday communication.  The frequent use of such labels by subject matter experts risks ostracizing the very people we seek to help while reinforcing erroneous public beliefs that these people are beyond help. 

In August 2018, ATSA’s journal Sexual Abuse published a guideline encouraging the use of person-first language to describe individuals and groups in manuscript submissions (Willis & Letourneau, 2018).  In this article, we encourage all of our ATSA friends and colleagues to consider promoting person-first language more broadly – from the names of treatment programs and agencies, to report writing and during informal conversations with family and friends.  First, we summarize some of the problems with the offense and attraction-based labels commonly assigned to our clients. 

Problems with the “sex offender” and other commonly used labels

Labels promote misperceptions.  The “sex offender” label suggests that is who someone is. Inherent in the label is the assumption that “once an offender, always an offender.” Indeed, Harris and Socia (2016) found that survey respondents who read about “sex offenders” rated them as less responsive to treatment and were more supportive of contemporary sex crime policies than survey respondents who read about “people who have committed crimes of a sexual nature”.  Findings were even more robust for the “juvenile sex offender” label.  Yet it is well established that sexual recidivism base rates are low, and moreover, that rates decline with time spent offense-free in the community (Hanson et al., 2014; Hanson et al., 2018).  Offense-based labels further suggest that individuals with a history of sexual offending represent a homogenous group whose members all present a comparable likelihood of reoffending.  However, individuals who commit crimes of a sexual nature are diverse across most characteristics (apart from gender), including with respect to their risk profiles.  Some “sex offenders” present an above average risk of sexual recidivism, perhaps due to a combination of numerous priors, atypical sexual interest, and low connection to social institutions, whereas others assigned the same “sex offender” label present a risk of sexual recidivism indistinguishable from people with only nonsexual offense convictions (see Hanson et al., 2018). 

Offense-based labels like “sex offender,” “child molester” and “rapist” convey little about the etiology of offending, treatment needs, or future risk of specific individuals.  As such, these labels lack validity.  By contrast, other labels commonly assigned to persons who have offended or are at risk of offending are based on valid constructs (e.g., “psychopath”, “pedophile”).  Even so, these labels carry negative connotations and risk stigmatizing the person behind the label (Imhoff, 2015).    

Labels risk stigmatizing individuals and groups.  It is well documented that individuals labeled a “sex offender” struggle integrating into society; for example, they struggle securing stable housing and employment (for a review of literature on attitudes towards persons who have sexually abused, see Harper, Hogue, & Bartels, 2017).  Many labels commonly used by professionals might be perceived as stigmatizing and pejorative, and not self-selected by the individuals and groups to whom they are assigned.   Respect for the dignity of all persons is a core ethical principle in codes of ethics across the helping professions (e.g., American Psychological Association, 2010a; Code of Ethics Review Group, 2012; The Australian Psychological Society, 2007; The British Psychological Society, 2009), and addressed explicitly in the American Psychological Association (APA) Publication Manual (APA; 2010b).  Specifically, the APA manual states that “A label should not be used in any form that is perceived as pejorative; if such a perception is possible you need to find more neutral terms” (p. 72). 

Of course, individuals vary in their perceptions of labels to the extent that some self-select labels we might generally wish to avoid using.  Such a contradiction is evident amongst the population of individuals with sexual interest in young children.  Some individuals choose to use labels that acknowledge their sexual interest in children – for example, they might refer to themselves as “minor-attracted persons” or “virtuous pedophiles” (see also Malone, 2014).  The APA Publication Manual encourages authors to “respect people’s preferences; call people what they prefer to be called” (p. 72).  When working with an individual or writing up a specific case, it is straightforward to follow this recommendation to respect an individual’s labeling preferences.  However, how might professionals respect different labeling preferences when referring to groups of people presenting with similar psychological phenomena (e.g., pedophilia)?  Person-first language offers a neutral solution.

Person-first language

As its name suggests, person-first language separates a person from a behavior, condition or disorder (e.g., “persons with sexual offense histories,” “individual with sexual interest in children”, “child/adolescent with sexual behavior problems”).  Person-first language encourages us to describe individuals and groups with greater precision, increases the likelihood that others will perceive these individuals as amenable to intervention, and reduces the likelihood of demeaning those we describe by assigning a label that they might not self-select (see Willis, in press). 

In the broader educational and psychology literature, person-first language is commonplace.  For example, we no longer refer to individuals with intellectual disabilities as “mental retards” or even “intellectually disabled,” and persons with schizophrenia could not be labeled “schizophrenics” in modern journal articles.  We believe that with time and effort, similar change is achievable in our field.  It might be argued that individuals who have engaged in harmful or illegal sexual behavior do not deserve the same considerations as individuals with intellectual or mental health problems.  Many would say that people who cause harm, particularly sexual harm, deserve the labels they have been assigned.  We disagree.  Human rights, including the right to dignity, apply to everyone, including people who have caused harm.  While it is important to stigmatize harmful behavior, it is counter-productive to stigmatize people

How might ATSA members promote person-first language?  Sexual Abuse has set a precedent and we hope that the broader ATSA membership will follow.  We encourage ATSA members to look closely at the names of the agencies they work for, the treatment programs they run, and the academic courses and professional training programs they offer.  Are the names and titles of these efforts consistent with a person-first approach?  Or do they inadvertently reify the image of certain groups as homogenous and high risk?  Likewise, we encourage ATSA members to examine how they describe their clients or research subjects when talking with the media, during court appearances, and within clinical and scholarly writings.  Beyond work settings, we encourage ATSA members to reflect on how they describe their work and client groups to friends, family and others.  As professionals, we model for the public how to talk about and, therefore, how to think about the people with whom we work. 

We (Gwen and Elizabeth) have each used the very labels that we now protest; we recognize that changing from offense-first to person-first language is a process. We can attest that it gets much easier with practice.  We are also aware that many ATSA members initiated person-first usage long before we did and we are grateful for these efforts.  ATSA members have grappled several times with our organization’s title and will no doubt do so again.  Regardless of whether we change the ATSA name, we can all change how we describe those with whom we work.  Anything we do that makes it easier for others to view the people with whom we work as people will make our work easier and more effective. 


American Psychological Association. (2010a). Ethical Principles of Psychologists and Code of Conduct (With the 2010 Amendments). Retrieved from http://www.apa.org/ethics/code/principles.pdf

American Psychological Association. (2010b). Publication Manual of the American Psychological Association (6th ed.). Washington, D.C.: American Psychological Association.

Beier, K. M., Ahlers, C. J., Goecker, D., Neutze, J., Mundt, I. A., Hupp, E., & Schaefer, G. A. (2009). Can pedophiles be reached for primary prevention of child sexual abuse? First results of the Berlin Prevention Project Dunkelfeld (PPD). The Journal of Forensic Psychiatry & Psychology, 20, 851-867. 10.1080/14789940903174188

Caldwell, M. F. (2016). Quantifying the decline in juvenile sexual recidivism rates. Psychology, Public Policy, and Law, 22, 414-426. 10.1037/law0000094

Carich, M. E., & Musack, S. (Eds.). (2015). The Safer Society Handbook of Sexual Abuser Assessment and Treatment. Brandon, VT: Safer Society Press.

Code of Ethics Review Group. (2012). Code of Ethics for Psychologists Working in Aotearoa New Zealand.   Retrieved July 6, 2016, from http://www.psychologistsboard.org.nz/cms_show_download.php?id=237

Hanson, R. K., Harris, A. J. R., Helmus, L., & Thornton, D. (2014). High-Risk Sex Offenders May Not Be High Risk Forever. Journal of Interpersonal Violence, 29, 2792-2813. doi: 10.1177/0886260514526062

Hanson, R. K., Harris, A. J. R., Letourneau, E., Helmus, L. M., & Thornton, D. (2018). Reductions in risk based on time offense-free in the community: Once a sexual offender, not always a sexual offender. Psychology, Public Policy, and Law, 24, 48-63. doi: 10.1037/law0000135

Harper, C. A., Hogue, T. E., & Bartels, R. M. (2017). Attitudes towards sexual offenders: What do we know, and why are they important? Aggression and Violent Behavior doi: 10.1016/j.avb.2017.01.011

Harris, A. J., & Socia, K. M. (2016). What’s in a name? Evaluating the effects of the “sex offender” label on public opinions and beliefs. Sexual Abuse: A Journal of Research and Treatment, 28, 660-678. doi: 10.1177/1079063214564391

Imhoff, R. (2015). Punitive attitudes against pedophiles or persons with sexual interest in children: Does the label matter? Archives of Sexual Behavior, 44, 35-44. doi: 10.1007/s10508-014-0439-3

Letourneau, E. J., Eaton, W. W., Bass, J., Berlin, F. S., & Moore, S. G. (2014). The Need for a Comprehensive Public Health Approach to Preventing Child Sexual Abuse. Public Health Reports, 129, 222-228.

Malone, L. (2014). You're 16. You're a Pedophile. You don't want to hurt anyone. What do you do now?   Retrieved from https://medium.com/matter/youre-16-youre-a-pedophile-you-dont-want-to-hurt-anyone-what-do-you-do-now-e11ce4b88bdb#.uj2ff35j6

Prescott, D. S. (2009). Building motivation for change in sexual offenders. Brandon, VT: Safer Society Press.

Sawyer, S. P., & Jennings, J. L. (2016). Group Therapy with Sexual Abusers: Engaging the Full Potential of the Group Experience. Brandon, VT: Safer Society Press.

The Australian Psychological Society. (2007). Code of ethics. Melbourne, Australia: The Australian Psychological Society.

The British Psychological Society. (2009). Code of Ethics and Conduct. Retrieved from http://www.bps.org.uk/system/files/Public%20files/aa%20Standard%20Docs/inf94_code_web_ethics_conduct.pdf

Willis, G. M. (in press). Why call someone by what we don’t want them to be? The ethics of labelling in forensic/correctional psychology. Psychology, Crime & Law doi: 10.1080/1068316X.2017.1421640

Willis, G. M., & Letourneau, E. J. (2018). Promoting accurate and respectful language to describe individuals and groups. Sexual Abuse, 30(5), 480-483. 10.1177/1079063218783799

Yates, P. M., Prescott, D. S., & Ward, T. (2010). Applying the Good Lives and Self Regulation Models to sex offender treatment: a practical guide for clinicians. Brandon, VT: Safer Society Press.

[1] Labels will not be used by the authors unless referring to current usage, which will be indicated by quotation marks or italics.


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