Vol. XXXI, Issue 4
Fall 2019
Text Only Version
In This Issue
REGULAR FEATURES
Editor's column
Presidentís message
COMMITTEE UPDATE
International Committee update
FEATURED ARTICLES
What's happening in Italy?
Registration and disclosure: Lessons learned or same old song and dance?
International members survey 2018 part 1: Practitioner knowledge, training and experience
International members survey 2018 part 2: Practitioners attitudes to and understandings of community integration
CLINICAL CORNER
Eye Movement Desensitization and Reprocessing (EMDR): Exploring a new avenue for sex offender treatment
STUDENT'S VOICE
Incel inside: Understanding involuntary celibates through dating app experiences
BOOK REVIEWS
International Perspectives on the Assessment and Treatment of Sexual Offenders
Learning Difficulties and Sexual Vulnerability: A Social Approach
ATSA NEWS
ATSA Board of Directors election results
Journal updates for membership
Forum Newsletter Editorial Board
New Membership Coordinator message
Welcome ATSA's newest members
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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
What's happening in Italy?
Carla Maria Xella

CoNTRAS-TI 1st Conference:

A Network Against Sexual Abuse.

On May 26, 2019, something new happened in Milan, Italy. A network of professionals and agencies engaged in sexual offending research and treatment named CoNTRAS-TI[1] had its first national conference. This could seem mundane: Many conferences are held in this field all around the world, and this was a small one: only one day, five presentations, two roundtables… a small step maybe, but a leap, if not so “giant,” and definitely big for our country.

A public approach to sexual offending in Italy and CoNTRAS-TI

So far, the public institutions’ approach to the issue of sexual abuse has been motivated by punishment. Among European countries, Italy is one of the few lacking any public action regarding the treatment of people who have committed or are at risk of committing sexual abuse.

Recently, a new bill named the Red Code – aiming to deal with interpersonal and sexual violence in a more efficient way – was issued. A more rapid pathway for victims of sexual or intimate partner violence to be heard by the police was established, but the approach to perpetrators was, once again, inspired mainly by punishment. The length of the sentences has been increased up to 20 years, but treatment programs in prison are bound by private agreements between prison administrations and specialized agencies, with no funds from the state. Treatment delivered by specialized agencies is also a stipulation for conditional release. Although this could seem like good news, conditional release is only expected for minor crimes, like possession and distribution of child pornography. That means, of course, that those who committed contact sexual crimes have little chance of being treated, either in prison or in the community. Nevertheless, some programs for the treatment of sexual offenders, both in detention and in the community, do exist, but currently depend on uncoordinated personal initiatives, or are funded by special projects from the EU. Consequently, treatment programs are aleatory and insufficient. 

With respect to risk assessment, the funding approved by the former government for translating and validating the Static-99R and STABLE-2007 has been cancelled. The agencies involved, some of which are public administrations, will be funded by a private foundation. Risk assessment currently is based on unstructured clinical judgement by overworked prison psychologists lacking specific training in sexual offending. 

The common needs of the providers of these programs are, of course, to share experiences and practices. That’s why, in October 2017, the national association named CoNTRAS-TI was founded. CoNTRAS-TI aims to share research data and best practices among its members and with members of other similar international associations, to foster collaboration with public institutions, and to promote best practices in sex offender treatment and community reintegration. Last year CoNTRAS-TI and ATSA signed their affiliation and a precious collaboration was established – one that will help Italian professionals keep informed about international research and practice.

The conference

The Conference’s title was A Network Against Sexual Abuse. Knowledge, Assessment, Prevention. Its main aim was to promote the exchange of knowledge among those at various levels who are concerned with sexual abuse. That’s why the conference included not only professionals dealing with perpetrators, but also people like Col. Antonio Manzi, Carabinieri Force; Judge Anna Maria Gatto, President of Pavia Court; and Gloria Soavi, President of CISMAI, the Italian network of organizations and professionals dealing with victims of child abuse. This deliberate choice was meant to convey that we are not on opposite sides – as frequently considered, not only by the general public – but we are all together struggling to make society safer.

The Conference was opened by Laura Emiletti, President of CoNTRAS-TI, who presented the association, its story, and its goals. She stressed mainly the need for a deep change in the public approach to sexual abuse. An effort must be made to overcome public denial and minimization regarding issues such as the number of victims and the severity of the harm inflicted, to enhance the prevention of crimes, protection of victims, and rehabilitation of the offenders, in the spirit of restorative justice. Emiletti, like other speakers, expressed her concern for the state of things in Italy. Specifically, she  spoke about the  oversimplification of such a complex issue as sexual abuse, the solutions proposed by politicians (apparently only motivated by the desire for public approval)  and the withdrawal of (already scarce) funding from projects and agencies involved in prevention and treatment of sexual aggression for both victims and perpetrators. An example of this conservative political wave is the proposed law for the so-called “chemical castration” of sexual abusers. This law states that the judge presiding over a case of child sexual abuse must order anti-androgenic treatment (AAT) for the perpetrator. The approval of a physician is not required. After a prolonged discussion, the proposal has not been included in the Red Code bill mentioned above, but has not been completely rejected. 

The issue of chemical castration was addressed by many speakers in one way or another. The first speaker was Fabian M. Saleh, from Harvard University, who opened the morning with a presentation concerning anti-androgenic treatment. The presentation made clear that AAT is to be administered only as a part of case management, only when there is a real need for reducing high-risk deviant sexual arousal, and only if the client has not responded to psychological or first-line psychiatric intervention. The issue of consent has also been explored, such that, is there real consent when AAT is the condition for release? According to Saleh, an effective treatment plan evolves from a comprehensive assessment of multiple influences affecting the offender’s (patient’s) life and his/her treatment and risk management needs.

As a member of the International Committee of ATSA and President of CoNTRAS-TI’s Scientific Committee, I was the second speaker of the morning, with a presentation centered on the international approaches to sex offender assessment and treatment. I stressed how in many western countries assessment and treatment of sex offenders is an established practice, even though many differences and even problems still exist. Some examples were presented from Canada, USA, UK, Belgium, Netherlands, Germany, Denmark, as well as Latvia, which built an efficient system of sex offender management in no more than 5 years, starting from nothing. As for Germany, I talked about the Dunkelfeld Prevention Project, which aims to enhance behavioral control and reduce associated dynamic risk factors in self-motivated pedophiles/hebephiles who ask for help in a public hospital in Berlin. In Germany, reporting of a suspected or known sexual crime is not mandatory for clinicians, so privacy is completely assured. Denmark was mentioned especially because of the use of AAT if needed, for sex offenders serving a long prison sentence (more than 5 years) as a condition for release with supervision. Of course, AAT is part of the overall management of the case. Indeed, only in Poland and Czech Republic (and 8 American states), is chemical castration part of a sentence, (i.e., is intended as a punishment, and not as a therapy administered as part of a complex treatment).

Col. Giorgio Stefano Manzi, Carabinieri Force, now Professor of Criminology at the Superior School of Carabinieri, has been professionally involved for many years in the fight against child abuse. The focus of his presentation was on the importance of contrasting the cultural justification of child abuse. He spoke about the so-called Pedophiles’ Party in the Netherlands, NAMBLA in the USA, the Ganymede Collection in Canada, the Lolita Grupo in Spain – associations aimed at making child sexual abuse look “normal” and expressing the right of boys and girls to enjoy sex at any age.

He also named the Utrecht Convention (1974) where families of the victims were invited to support the relationship between the child and his/her abuser, as part of his/her healthy development. The boundary between freedom of expression – a core value of EU legislation – and criminal solicitation is always a slippery one. Since 2012, according to the Lanzarote Convention against child abuse, the Italian Penal Code (Art. 414bis) specifically punishes the solicitation of pedophilia and child pornography, even if justified by ‘historical’ or ‘cultural’ reasons. This is a powerful tool to contrast the cultural normalization of child abuse, which is often used by sexual offenders to rationalize child sexual abuse.

The contribution of Judge Anna Maria Gatto was not exactly a presentation; rather it was the story of a change of perspective and a painful growing of awareness. “Every time that, as a judge, I was dealing with cases of sexual abuse…when giving my sentence what I would think was the title of that book of yours: Let’s throw the keys away!” She was referring to a book written a few years ago by me and my colleague Paolo Giulini, about the program held in Milano-Bollate prison by C.I.P.M., Centro Italiano per la Promozione Della Mediazione (a program which remains one of the few Italian examples of sex offender treatment). The title was “Buttare la chiave?” or “(Nothing to do but) Throw the keys away?” 

Gatto went on to say, “But one day I was invited by Paolo to participate in a treatment group. And then something changed in me: What I was used to hearing in court was, “But I didn’t do it!” and now, here is one of these guys saying, “My name is XY, I’m here because I sexually abused my partner’s teen daughter.” And I realized that they CAN change, and something can be done to foster this change.”

This awareness, nevertheless, was also a painful one, because the institutional approach to this issue is still only based on punishment, and the judge has no means to mandate what our Constitution says in Art. 27: “All criminal sanctions should have the aim of rehabilitating the offenders.” The lack of treatment programs, of facilities for very high risk or psychiatric offenders, of funding, of supervision/support after release, prevents any sort of rehabilitation. “And,” Gatto concluded, “lucky for me I’m 67 and about to retire! When I chose to be a judge, never would I have thought that one day, I would be supposed to sentence someone to chemical castration without having any medical competence!” 

The last speaker of the morning was Gloria Soavi, President of CISMAI, a network of associations aimed to protect and treat the victims of child abuse. She spoke about how the issue of child abuse, especially sexual abuse, is still one of denial and minimization. No public data are available. Soavi said that the only Italian research about the occurrence and frequency of child abuse has been conducted by two private associations, CISMAI and Terre des Hommes, and not by a public institution. 

Child abuse pops up in newspapers when a single, especially cruel crime draws public attention, followed by demands for the punishment of the “ogres.” Sometimes, stricter legislation is the consequence, but more often than not everything is forgotten… until a new case is in the spotlight. Public (and political) attitude toward sexual abuse vacillates between calling for the death penalty and denial of the occurrence of sexual abuse. What is lacking, Soavi said, is a cultural awareness of trauma and its consequences, and that sexual abuse is preventable.

The roundtables

The first roundtable was chaired by the criminologist Paolo Giulini, Secretary of CoNTRAS-TI. Some Italian experiences of research and treatment were presented. Amelia Ciompi (Prison Administration Department) presented the result of a recent survey about sexual offenders convicted in Italian prisons. Considering that some offenders are convicted for several sexual crimes, their number can be estimated around 3,000, which is a small number, given the results of other surveys about sexual victimization, against both women (est.1,369,000 in the last 5 years) and children (7-10% per year according to CISMAI). Ciompi stressed some well-known critical issues – lack of funds, lack of training, and prison overcrowding – and presented the 15 treatment programs operating in Italy so far. It’s worth saying that only 5 of them are using validated risk assessment tools.

After Amelia Ciompi were two clinical presentations: Davide Dettore (University of Florence) explained his (cognitive-behavioral) model for the treatment of internet sexual offenders, and Dante Ghezzi (TIAMA, Milan) addressed the topic of juvenile sex offenders and presented a clinical case.

Sara Veggi (University of Turin) presented, on behalf of Georgia Zara, the Italian validation and translation of the CID-SO, a tool for denial assessment in sexual offenders developed by Sandy Jung. Finally, two of the programs inspired by international guidelines using risk assessment tools were presented. Maura Garombo described the Vercelli prison program, an Italian adaptation of the British SOTP. As an experimental adjunctive treatment, participants also received EMDR group treatment, as developed by Artigas and colleagues (2009). The results of this innovative approach, though not published, are nevertheless encouraging. Andrea Scotti explained the C.I.P.M. model of treatment (Prison of Milan Bollate and Community of Milan) as an integrated program aimed at the healthy reintegration of an offender in his community, thanks to a careful assessment of risk and protective factors. The role of COSA (Circles of Support and Accountability) was also described.

The focus of the second roundtable, chaired by the journalist Piero Colaprico (La Repubblica), was the public perception of sexual offending and the role of media in presenting either a distorted or accurate view. The participants were criminologist Francesca Garbarino; journalist Paolo Lambruschi (L’Avvenire); Paolo Colonnello, President of the Journalist’s Disciplinary Board of Milan Region; and director Claudio Casazza, who shot a documentary movie about the treatment program of Milan-Bollate prison. All participants agreed about the harmful effects of spreading hate and fear through the oversimplification of complex issues, instead of a culture of prevention and rehabilitation. A different kind of public communication is possible, as Claudio Casazza illustrated with his documentary, a simple registration of an entire year of group work of 15 sex offenders in a prison ward, whose (not explicit, but clear) message is that change is neither easy nor straightforward, but is possible. 

And this is exactly the conclusion we can draw from our conference: Even in Italy, even in a political situation more and more intolerant and populist, even with a dramatic lack of funds, things can slowly change. Laura Emiletti closed the conference, announcing the next steps of CoNTRAS-TI, which are: creating a website with general information and special resources for members, editing and publishing the conference’s proceedings, strengthening the bonds with ATSA and other international associations, and promoting CoNTRAS-TI over the media and social networks.

The next conference was also announced, which will be held in Florence in fall 2020.

References

Artigas L., Jarero I., Alcald N., & Lopez Cano T. M. (2009).The EMDR Integrative Group Treatment Protocol (IGPT). In Luber M. (Ed.), EMDR Scripted Protocols. Basic and Special Situations. New York, NY: Springer Publishing Company


[1] in English: National Coordination of Treatment and Research about Sexual Offending – Italian Experiences, and the acronym can be translated in Pathways to stop it)

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