ATSA ForumVol. XXIX, No. 4 Fall 2017
Editor's Note
by Heather Moulden, Forum Editor
It feels like I was just writing to you with
well wishes for summer, and here we are embracing the autumn with already
falling leaves in this part of the world. While summer is often a time of
relaxation, this did not appear to be the case for the contributors to our fall
issue of the Forum. They were busy reflecting and writing so that they could
share their clinical wisdom with you, ATSA members. I’m sure you will find this
issue full of helpful and practical resources just in time for “back to
school”.
Our editor emeritus, Robin Wilson, reminds us
of the impact of doing our work and how to take care so we can keep doing it.
He provides a succinct summary of some of the key points from the literature on
vicarious/secondary trauma, and includes references to resources and reading to
facilitate the process of self-care, which for many clinicians, falls to the
wayside after the multitude of other work and life demands.
Two other feature articles provide very practical
clinical advice and direction for domains of practice and intervention that we
know relatively little about. David Delmonico and Elizabeth Griffith share
their clinical expertise working with individuals who have engaged in online
offending. Specifically, they highlight the importance of addressing technology
directly within treatment approaches and offer insight and helpful exercises to
facilitate self-awareness, challenge thinking, and navigate the web in a
healthy way.
I was also very excited to read the article
by Christin Santiago-Calling, in which the benefits of therapeutic recreation
for adolescents was introduced as a novel and innovative means of intervention.
The article makes a compelling case for the integration of this mode of work into
multidisciplinary team approaches for residential treatment. Christin includes
excellent examples of activities and their potential mechanisms of change,
making it easy for readers to try them out in their own practice.
Staying with adolescents, following the new
guidelines, many members wondered about the guidance offered surrounding polygraph for youth. In this issue our FAQ column was jointly authored by
Phil Rich and Danielle Harris (Adolescent and Research Committee Chairs, respectively)
to provide the rationale and additional clarification regarding this issue.
Continue to send me your questions regarding research translation or clinical
practice so we can get you the answers you need.
Other committees have been busy updating materials
and gearing up for the conference. From the Ethics committee, Becky Palmer
provides a helpful summary of some of the major changes to the revised and
updated ATSA Professional Code of Ethics. Thanks to Becky for helping members
to wade through this document by signalling some of the pertinent additions and
changes. The student body of ATSA is looking
forward to welcoming student conference attendees and showcasing their
significant contributions at the conference. Committee chair Andrew Brankley
provides a helpful guide and schedule that will prepare returning and new
student attendees alike. For non-student members this piece is a summary of the
impressive work our students do and all they contribute to the conference. Many
events are not just for students (e.g. data blitz), and a review of all the
events and advice will benefit many first time conference attendees. As an example
of the quality of the work produced by ATSA students, our student article by
John Michael Falligant, summarizes his exciting work looking at novel
behavioral assessment procedures for the assessment of deviant sexual
preferences.
I hope you enjoy the fall issue of the Forum
and find it as interesting and exciting as I did. As always, I look forward to
reading your articles and I am happy to work with you on developing ideas for a
Forum piece.
Heather M. Moulden
ATSA Forum Editor
President's Message
by Michael Miner, ATSA President 2016-2017
As summer fades into fall, the ATSA staff is preparing for
the Annual Research and Treatment Conference, this year in Kansas City,
Missouri. The conference committee,
co-chaired by Amanda Faniff and Marc Schlosberg, has put together what promises
to be an engaging and enlightening program.
Plenary speakers included Patty Wetterling, who is always inspiring and
provides an astonishing perspective given her personal loss. On Saturday, Pamela Mojia from the Berkeley Media
Study Group and Nicole Pittman from the Center on Youth Registration Reform
discuss their on-going work designed to shift the public narrative around
prevention of sexual offending. In
addition, there are the usual range of pre-conference workshops and concurrent
session with speakers both familiar and new. Following up on last year’s
successful pre-conference workshop aimed specifically for researchers, Tony
Beech will lead an interactive workshop, “Challenges and Debates in Risk
Assessment: Moving the Field Forward or Not?”
Our theme, Creating Balance, highlights the many competing interests,
orientations, and perspectives that must be balanced in moving the mission of
ATSA forward and making this a better world for everyone.
There are a number of new things at this year’s
conference. For the first time,
continuing medical education credits will be offered. There are also some exciting new activities. The day before the conference, all conference
attendees are invited to participate in a Giving Back to our host community by
joining ATSA staff and other colleagues in volunteering at Sunflower House, an
organization that assists children who have been physically and sexually abused.
We will be performing a range of
services, so there should be a project for everyone’s interests. Also new this year is the Public Policy
Reception, which provides an informal gathering for those interested in ATSA’s
public policy activities and influencing public policy. I hope to see all of you there.
ATSA’s Board has moved forward with the implementation of
our strategic plan, with all committees developing goals and objectives for the
next year. We had some changes on the
Board. Andy Harris and Pamela Yates
resigned their positions. So, we welcome
Katie Gotch as the Public Policy Chair and Anita Schlank as the Adult Clinical
Representative.
A final important initiative that the Board has been working
on is the development of a funds development plan. The Board has adopted a plan that provides a
framework for developing a more diverse set of funding streams and looking for
mechanism for philanthropic giving. More
information will be forthcoming as this plan takes shape and more specific
activities are designed.
In closing, I hope to see you all in Kansas City this October. I thank you all for supporting
ATSA and its mission, and I applaud all the important work you do every day to prevent
sexual abuse.
Michael Miner
Why is Juvenile Polygraph Not Recommended by ATSA?
Phil Rich, Ed.D., LICSW ATSA Executive Board Juvenile Practice Representative
Danielle Harris, Ph.D. ATSA Executive Board, Research Committee Chair
ATSA’s
new adolescent practice guidelines, available to ATSA members through the ATSA
website, do not recommend the use of the polygraph for adolescents. As a body
wishing to support and emphasize evidence-informed and evidence-based practice,
ATSA has assumed this position because there is a lack of evidence to support the
use of polygraph examination practice with juveniles. Further, ATSA’s position
reflects our priority to “first do no harm,” as well as concerns voiced by some
that the polygraph may be harmful to the wellbeing of the juvenile (for
instance, Chaffin, 2011). ATSA both supports the importance of client wellbeing
in treatment and avoiding treatments that may be coercive whenever possible, as
well as building treatment upon evidence, rather than using treatments that
have no known established treatment effects. As with all professional
guidelines the recommendation is meant to be aspirational with respect to
practice, and does not reflect or replace local and/or applicable statutes,
provisions, requirements, and other standards that may govern or shape
practice. Recognizing this, the guidelines are designed to simply encourage
practitioners “to take steps to achieve an appropriate resolution in cases
where a conflict between these guidelines and legal and professional obligations
occur.”
The
polygraph is somewhat unusual in that, in this case, ATSA’s recommendation is
not based on evidence that juvenile polygraphs are harmful or ineffective. The
position was neither taken with respect to whether or not sexually abusive
youth acknowledge more victims or sexual behaviors than they might otherwise
have acknowledged, nor with respect to the discovery of additional victims of
sexual abuse, who may then themselves get additional help. ATSA’s
recommendation is instead based on a lack of evidence for treatment effect or
efficacy, as well as the possibility that using the polygraph to engage the
young person in greater honesty and less dissimulation, or to get to the
“truth,” may in fact be a harmful process, and/or simply ineffective at further
increasing the effect of treatment on the young person.
In
many, cases it is safe to say that we have treatments and approaches to
treatment that are informed by available and consistent research, even if not
empirically validated, in which empirical validation is the surest and most
concrete form of evidence. However, it must be acknowledged that that level of
surety is rare in our field. Nevertheless, we do have treatments that are
supported and informed by research into effective and central aspects of
treatment and rehabilitation, improved mental health, desistance from
antisocial behaviors, and engaging in the treatment process itself. Indeed,
this research forms the foundation upon which much of the adolescent practice
guidelines is built. In the case of the
polygraph, there is, at best, only inconsistent evidence that it is effective in
accurately distinguishing between truth and dishonesty (American Psychological
Association, 2004; National Research Council, 2003). There is still less evidence
about its use with juveniles and there is an absence of empirical evidence that
demonstrates its value as a treatment intervention (Jensen, Shafer, Roby,
& Roby, 2015). Finally, it remains unknown whether the use of polygraph
examination is associated with either gains in treatment or the further
reduction of recidivism in individual clients (Rosky, 2012).
American
Psychological Association( August 5, 2004). The
truth about lie detectors (aka polygraph tests). Retrieved on-line: http://www.apa.org/research/action/polygraph.aspx
Chaffin,
M. (2011).The case of juvenile polygraphy as a clinical ethics dilemma.Sexual Abuse: Journal of Research and
Treatment, 23, 314-328.
Jensen,
T. M., Shafer, K., Roby, C. Y., &Roby, J. L. (2015).Sexual history
disclosurepolygraph outcomes: Dojuvenile and adult sexoffenders differ?Journal of Interpersonal Violence, 30,928
–944.
National
Research Council (2003).The polygraph and
lie detection.Committee to Review the Scientific Evidence on the
Polygraph.Division ofBehavioral and Social Sciences and Education. Washington,
DC: The NationalAcademies Press.
Rosky,
J. W. (2012). The (f)utility of post-conviction polygraph testing. Sexual Abuse: A Journal of Research and
Treatment, 25, 259-281.
Responding to Problematic Technology Use: Creating a Therapeutic Toolbox
David L. Delmonico, Ph.D. Duquesne University Pittsburgh, Pennsylvania
Elizabeth J. Griffin, MA, LMFT Internet Behavior Consulting, LLC Minneapolis, Minnesota
Correspondence: David
Delmonico; Duquesne University; Canevin Hall; Pittsburgh, PA 15236; (412)
396-4032; delmonico@duq.edu
David L. Delmonico, Ph.D.
|
Elizabeth J. Griffin, MA, LMFT
|
There is a growing body of research
related to individuals who use digital technology to commit their sexual
offense. Much of the focus in the field
has been on understanding the characteristics of online sex offenders, and the
risk they pose to the community; however, little has been written about
treatment of the individuals who commit an online sexual offense. A number of models specific to working with
sex offenders have been applied to the treatment of online sex offenders. One model that has been found to be useful is
the Risk-Need-Responsivity model. The Risk-Need-Responsivity (RNR) model
suggests treatment providers think in terms of identifying the level of risk to
the community, identifying the criminogenic needs, and developing treatment
strategies based on specific client needs (Andrews & Bonta, 2010).
The risk principle states that the
intensity of treatment should be matched to the level of risk with the most
intensive levels of intervention reserved for higher risk offenders, and lower
intensity or no intervention applied to lower risk offenders. Research regarding individuals who commit
their sexual offenses using technology suggests that many are low risk for
sexual recidivism (Seto, 2013). Online-only sex offenders have been found to
have recidivism rates nearly one‑half (approximately 7%) (Faust, Renaud, & Bickart, 2009; Seto, 2011) of their contact counterparts
(approximately 13%) (Hanson & Morton-Bourgon, 2005). Given this low recidivism rate, it has
been suggested that online sex offenders, with no history of a past contact
sexual offense, need little to no treatment. However, initial research has
identified potential dynamic risk factors to address online sex offenders who
are in treatment.
The need principle states the most
effective interventions are those that target a client’s criminogenic needs, or
dynamic risk factors. Dynamic risk
factors are those factors associated with risk for re-offending, but which can
be changed through intervention, thereby reducing risk and recidivism. Given the limited research regarding online
sex offenders, the specific dynamic risk factors that lead to risk reduction have
yet to be identified (Henshaw, Ogloff, & Clough, 2017; Seto, 2013). The research has identified several psychological
problems and behaviors associated with online sex offending. These include (1)
emotional regulation (Beech & Elliott, 2009); (2) social skills/intimacy
(Beech & Elliott, 2009); (3) deviant arousal (Beech & Elliott, 2009);
(4) online hypersexuality (Krueger,
Kaplan, & First, 2009)
and (5) problematic Internet use (Beech & Elliott, 2009; Taylor & Quayle, 2003).
Problematic Internet use is often an
overlooked area of intervention in sex offender treatment programs. There is
little information in the literature on how best to intervene with problematic technology
use among online sex offenders, and how to assist them in developing healthy
technology alternatives. The need for this information has become increasingly
important as courts are recognizing that broad restrictions against sex
offenders, regardless of the nature of the sex offense, or how technology was
used in the commission of the offense, are overgeneralized and violate an
individual’s freedom of association, speech, and privacy protections (Chan, McNiel,
& Binder, 2016). The courts are
recognizing that access to technology is necessary for the tasks of everyday
living, and denying access is likely to be unconstitutional. Additionally, a
literature review by Chan, McNiel, and Binder (2016) found there was no
evidence that restrictions or bans on individuals from the Internet and/or
social media were successful in reducing sexual offense behavior. Given the evolving technological landscape,
and the recognition of constitutional rights of individuals who commit sexual
offenses, most sex offenders will have access to technology and the Internet
with some limitations or monitoring.
When courts deny Internet access there
is little opportunity for individuals who committed their sexual offense in the
online world to learn healthy technology habits. Additionally, there is no opportunity to
practice and experiment with re‑integrating technology use while under the
guidance and support of community supervision and treatment. It is important to remember that clients will
eventually have access to technology; therefore, addressing problematic
Internet use and developing healthy technology habits while under supervision
is crucial. This article provides
treatment activities that address both problematic Internet use and the
development of healthy technology habits.
The treatment activities in this article will incorporate
elements of responsivity from the Risk-Need-Responsivity model. The responsivity principle states that
interventions should be delivered in a manner consistent with a client’s
learning style, abilities, and personal circumstances. Important considerations in the responsivity
principle include motivation to change, cognitive abilities, cultural
considerations, mental disorders, etc. In addition, it is important to consider adult
learning theory, which suggests information retention by adults is improved when
paired with multiple modalities (e.g., visual, kinesthetic, auditory, etc.) (Aivio,
1971; International Learning Styles of Australia, 2010).
Six practical treatment activities addressing
problematic Internet use are described below. While problematic “Internet” use
is the term in the literature, it is important to consider this behavior more
broadly given advancements in technology, therefore this article will use the
term problematic “technology” use. These
activities encompass the spirit of responsivity through their creativity and
multiple modalities for teaching information. A webpage has been established
where the complete treatment activities, along with instructions on using each activity
are provided. This webpage is the start
of a “Therapeutic Toolbox” that can be used to address problematic technology
use for online sex offenders. In
addition, the webpage lists other resources that may be useful when addressing
problematic technology use. The URL for
the webpage is: http://www.internetbehavior.com/therapeutictoolbox2017
Treatment Activities
The Psychology of Technology
- This
treatment activity is a three-part
activity designed to assist clients in understanding the influence of
technology on their behavior. It teaches concepts such as the Online
Disinhibition Effect (Suler, 2004) and The CyberHex (Delmonico, Griffin, &
Moriarity, 2001). These concepts assists the client in understanding that online
behavior can be influenced by various features of technology. The hope is that
clients will gain a better understanding of the influence of technology on
their behavior. In doing so, clients
will develop skills that are effective in managing the Psychology of Technology
in the online world.
Digital Footprints – Every individual that uses
technology leaves a Digital Footprint of the places he/she has been and the things
he/she has done. This exercise explains
the concept of the Digital Footprint, and the impact of digital footprints when
using technology. Clients are provided
with a copy of footprints printed on paper as a metaphor for their Digital
Footprint. They are then asked to do
several activities with the footprints to assist them in understanding and
visualizing how their use of technology may impact their Digital Footprint. The exercise ends with a reflection of the
client’s “online reputation” and how he/she can more positively influence that
reputation.
The “Lawyer”
- In this
treatment activity The “Lawyer” character is used as a metaphor to assist
clients with understanding the cognitive distortions/thinking errors that may
blame, justify, deny, or minimize their online sexual offense behavior. The
treatment activity includes a picture of an action figure that looks like a
lawyer. For many clients, their online sexual offense feels ego dystonic – that
is, they do not fully understand how or why they would allow such behavior to
occur. Their internal “Lawyer” comes to their aid by defending their
behavior and reducing the need to take full ownership and responsibility for
their actions. The goal of this exercise is to assist clients by teaching
them to become aware of their internal “Lawyer”, “own” and take responsibility
for the role their “Lawyer” has played in their online sexual offense behavior,
and finally, to learn to manage their “Lawyer” to the point that he/she is not
interfering with their treatment progress. In order to take full
advantage of this exercise, clinicians should consider purchasing an action
figure that looks like the “Lawyer”. The “Lawyer” can be purchased
through the website http://www.hermesweb.com. (No actual lawyers
were harmed in the creation of this treatment activity and apologies are
offered in advance if any lawyers are offended by the use of this metaphor).
Word
Webs – This treatment activity is
focused on individuals who have viewed child sexual abuse (child pornography)
images online. Due to the Psychology of Technology, individuals can often
frame the viewing of online child sexual abuse images as a victimless
crime. Those who possess/view/distribute child sexual abuse images can
minimize their behavior, and often feel they are different from individuals who
commit contact sexual offenses. The Word Webs can assist clients in
understanding that possessing/viewing/distributing child sexual abuse images is
problematic and not a victimless crime. In this treatment activity a
“foundation” world is placed in a center circle on a piece of paper (in this
case we have used the term child pornography on one word web, and the phrase
child sexual abuse images on another word web). Clients are then asked to
place associated words in empty circles around the page. When processing
this activity, clinicians should focus on comparing the two Word Webs with the
goal of helping the client understand that viewing child sexual abuse images is
not a victimless crime. This treatment activity can be used with variety
of “foundation” words and may be helpful to the individuals who have committed
an online sexual offense. Examples include sexting, BDSM, sting operations,
etc.
The
Technology Health Plan – This treatment activity is used to differentiate between
technological behaviors that are off limits from those that are healthy, safe,
and therapeutic. The activity uses three concentric circles – one red,
one yellow, and one green. What makes this treatment exercise effective is the
inclusion of a green zone that focuses on determining positive and healthy
technology-based behaviors. This activity is designed to develop client
awareness, and assist in setting set boundaries for healthy technology
use. The Technology Health Plan may be modified at various points in treatment
since clients will gain new awareness regarding their technology behaviors, and
will need to shift items between zones, delete items, or develop new
items. The reality is, regardless of technology restrictions, clients
will be exposed to technology and should be prepared in advance to deal with
such exposure. The Technology Health Plan accomplishes this goal.
The
Technology Toolbox – The
purpose of The Technology Toolbox is to remind clients (and clinicians) that
technology can be an asset in the treatment process. While it is easy to
focus on the negative aspects of technology, eventually, clients will need to
learn healthy ways to use technology in their daily lives. Clinicians should
work towards equipping clients with a Technology Toolbox in order to explore
healthy and safe technological resources. The treatment activity suggests
several areas of technology (e.g., webpages, chatting, social media, streaming,
podcasts, online universities, etc.) that can assist clients in understanding
the healthy use of technology and to provide alternatives to problematic
technology use. The client is encouraged to explore and find additional
technologies that may be helpful to continued healthy use of technology.
Clients are reminded throughout this activity that they need to seek permission
and guidance from their treatment provider, probation officer, and support
group before exploring positive and healthy technology behavior.
Summary
This article
highlights the needs posed by clients who use technology to commit online
sexual offenses, addresses the problematic use of technology, and provides
practical treatment activities encompassing the spirit of the responsivity
principle. Clinicians typically understand
that problematic technology use needs to be addressed in treatment; however,
they are often at a loss for how best to address this issue. The treatment activities in this article
provide clinicians with an opportunity to discuss with clients both problematic
and healthy use of technology. These
treatment activities are the start of creating a “Therapeutic Toolbox” that
will assist clients in developing positive and healthy technology habits. Visit http://www.internetbehavior.com/therapeutictoolbox2017/
for more information on the activities described in this article and other
resources related to problematic technology use.
References
Aivio,
A. (1971). Imagery and verbal processes.
New York: Holt, Rinehart, and Winston.
Andrews,
D. A., & Bonta, J. (2010). The psychology of criminal conduct.
Routledge.
Beech,
A. R., & Elliot, I. A. (2009).
Understanding online child pornography use: Applying sexual offense theory to Internet
offenders. Aggression and Violent Behavior, 14, 180-193.
Chan,
E.J., McNiel, D.E., & Binder, R.L. (2016). Sex offenders in the digital
age. The Journal of the American Academy
of Psychiatry and the Law, 44, 368-375.
Delmonico, D., Griffin, E.,
& Moriarity, J. (2001). Cybersex unhooked: A workbook for breaking free
of compulsive online sexual behavior. Gentle Path Press.
Faust, E., Renaud, C., &
Bickart, W. (2009, October). Predictors of re-offense among a sample of
federally convicted child pornography offenders. Paper presented at the 28th
annual conference of the Association for the Treatment of Sexual Abusers,
Dallas, TX.
Hanson, R. K., &
Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual
offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical
Psychology, 73(6), 1154.
Henshaw, M., Ogloff, J. R.,
& Clough, J. A. (2017). Looking beyond the screen: a critical review of the
literature on the online child pornography offender. Sexual Abuse,
1079063215603690.
International Learning Styles
of Australia. (2010). http://www.ilsa-learning-styles.com/ (Accessed on September 4,
2017).
Krueger, R. B., Kaplan, M.
S., & First, M. B. (2009). Sexual and other axis I diagnoses of 60 males
arrested for crimes against children involving the Internet. CNS spectrums,14(11), 623-631.
Seto, M. C. (2013). Internet
sex offenders. American Psychological Association.
Seto, M. C., Karl Hanson, R.,
& Babchishin, K. M. (2011). Contact sexual offending by men with online
sexual offenses. Sexual Abuse, 23(1), 124-145.
Suler,
J. (2004). The online disinhibition effect. Cyberpsychology & Behavior,7(3), 321-326.
Taylor,
M., & Quayle, E. (2003). Child pornography: An internet crime.
Psychology Press.
Looking After Ourselves and Each Other
Robin J. Wilson. Ph.D., ABPP McMaster University, Hamilton, ON Wilson Psychological Services LLC, Sarasota, FL
Why do we do this work?
A long time
ago, most of us who work in sexual violence prevention made a few critical
decisions. We were bright-eyed, bushy-tailed teenagers who had no idea what we
wanted to do when we “grew up.” In high school we talked with our friends and
family about the sorts of things we’d like to study in college or university. I
initially thought I would go to medical school and become a surgeon, but shaky
hands put the boots to that idea. That’s how I found psychology. I suspect many of
you also had academic dilemmas with which to contend, but you ultimately found
yourself in the humanities or studying something that would eventually lead to
work in social services.
Interestingly, I didn’t pick sexual violence
prevention as a career; it sort of chose me. After my third year of full-time
study in psychology at the University of Toronto, I needed a break and went
looking for a job. I managed to secure a position at the university’s
psychiatric teaching hospital, working for a Czech psychiatrist named Kurt
Freund who, it turned out, was the pioneer of the phallometric test (or penile
plethysmograph as it’s known more broadly in the USA). Working for Dr. Freund
was the single greatest influence on my future and after having had the
opportunity to conduct research, study human sexuality, and to rub shoulders
with other great practitioners in Canada, my career path was set. I’ve never
looked back and I can honestly say that I’ve never had a boring day at work.
However, that’s not to say that I haven’t also had some very upsetting days at
work.
We work in a field that brings us in contact with
people who have been harmed in a particularly intimate way, as well as with the
people who have harmed them. We’re in the public safety business. We work with
victims of sexual offenses to help them survive their experiences, knowing that
some of them – particularly young persons – may find themselves engaging in
abusive behaviors in the future. These abusive behaviors are not necessarily
always sexual in nature, nor are they
always directed at others; they may be more inwardly destructive. In our work
with offenders, we try to help them become desisters, instead of persisters.
So, why do we do this work? Because we want to make a
difference. We care about our families, friends, and communities and through
our interventions we strive to achieve the ATSA goal of making society safer.
But, this potentially comes at a cost to each and every one of us. We know that
the work we do can be hugely exhilarating when we see the successes of our clients,
but we shouldn’t kid ourselves that there aren’t darker experiences of which we
need to be mindful.
Why do we keep doing this work?
There is no
denying that working with persons with sexual behavior problems and antisocial
orientations is challenging (see Edmunds, 1997; Ellerby, 1998; Ennis &
Horne, 2003). Some of our clients are really good at “pushing our buttons.” How
do we offset our natural tendencies to be empathic and helpful with our natural
tendencies to be angry and upset at what our clients have done (or continue to
do)? Because we know the consequences of such strong emotional responses in
clinical environments. We also know that it is unconscionable to do nothing. So,
we work to reduce the number of potential victims, knowing that poorly managed
clients have the capacity – already demonstrated – to do tremendous harm. We
work to ensure that clients receive appropriate treatment and care according to
evidence-based practices, like the Risk-Need-Responsivity framework with which
we’re all so familiar. We work to ensure
that our clients are able to approximate a quality of life as close as possible
to that of others without sexual behavior problems – that’s the essence of the
Good Lives Model.
One of my
absolutely most favorite concepts I learned in school is that of the “balanced,
self-determined lifestyle.” I try to include this phrase in almost everything I
write (as I just did here) and I try to follow it myself and to instill it in others
around me. I co-opted this concept from the YWCA’s Life Skills Coach Training
program in Canada, as they did from Saskatchewan NewStart. NewStart was a basic
job readiness training program for Aboriginal Canadians in the mid-60s. Search
it out on Google, if you like; it bears a striking resemblance to many aspects
of the GLM, but some 30 years earlier. At its heart, a balanced,
self-determined lifestyle means making time for all the important elements of
life – self, others, community, job, leisure. And, it also encourages people to
think about the range of opportunities they have in life and to make good
choices while learning from mistakes. Clearly, our clients have not always done
both of these things, and that is perhaps why they land themselves in trouble.
Vicarious Trauma
Job stress is the result of a complex interaction
between the individual and the challenges of the job. Burnout involves
physical, mental and emotional exhaustion that is attributable to work-related
stress (Leiter & Maslach, 2009; Mayo Clinic, 2012). It is a uniquely human phenomenon that if a person
holds the capacity for empathy, he or she will experience distress when hearing
about terrible things that have happened to others. Have any of you ever
experienced anything like that – during an assessment, when reading police
reports or victim impact statements, or during a group or individual treatment
session?
Even though we weren’t there when our clients
committed their offenses, we are privy to intimate details of what happened.
This can lead to what is known as vicarious trauma (www.headington-institute.org; Pearlman & McKay, 2008). Because we are caring people and because we express
empathy and feel compassion, we often experience characteristics of
victimization just by hearing about what happened to others. This emotional
contagion can sometimes lead to compassion fatigue – a key component in
burnout. Ultimately, this is the cost of caring, but there are things we can do
about it.
High Risk Professionals
The
first thing we need to acknowledge is that we are members of a select group of
persons who are at higher risk for vicarious trauma and compassion fatigue.
These workers include, but are not restricted to:
- Counselors, Psychologists, Social Workers
- Health/Hospital Staff
- Emergency Workers
- Child Protection Workers
- Corrections Staff
- Law Enforcement Officials
- Court
Officials
- Volunteers
The effects of vicarious trauma and
compassion fatigue can be particularly pertinent to people who interview and
counsel trauma victims, those who work with victims and their families and,
notably for us, people who work with clients who have abused others.
Predictors and Mediators of Secondary
Traumatic Stress Effects
It’s important to recognize that not everyone
will be affected by troubling information or traumatic stress in the same way.
Some of us are really resilient and it doesn’t seem to matter much what we see or
hear – we get past it. Others, however, may find certain situations or
scenarios much more difficult to manage. The research on self-care and burnout
tells us that there are individual factors to consider, as well as situational and
environmental factors at play. This shouldn’t surprise us, as this is pretty
much the case with virtually everything in social services – it’s a mix of internal
and external variables.
Individual
Factors
A good bit of how we respond to traumatic
stress has to do with our personal history; that is, our personal experiences
of trauma, loss, and victimization and how we’ve managed to cope (or not) with
situations throughout our lives. Our personality style (and ego defenses) will
influence our coping style and the mechanisms we use to deal with difficult
situations – either at work or in other environments (e.g., have you ever found
yourself bringing work crap home with you?).
Another important consideration is current life
context. What’s happening for you outside of the work environment? Is your
teenage daughter or son having difficulties, are you having problems in
important relationships, has someone in your family or friend circle just
experienced a situation of abuse? All of these private life situations can
affect our ability to cope with difficult situations at work.
Here
are some individual risk factors to consider (see Pearlman & Caringi, 2009;
Pearlman & McKay, 2008):
- Lifestyle
balance
- Sense
of control
- Perceptions
of organizational intentions/commitment
- Perceptions
of fairness
- Fit
between values of self and organization
- Coping
skills and strategies
What
can we do to protect ourselves? I won’t get too far into that right now, but
some obvious recommendations are to take opportunities to increase our training base and to take the time to
debrief situations we experience at work with our colleagues and trusted
confidantes. And, keep in mind that we may need to practice what we preach: If
you have problems you can’t manage, maybe think about seeking professional
help.
Situational
Factors
As much as there are factors we bring to the
table in terms of our own personal makeup and experience bases, there are
factors over which we have a lot less control. In the beginning part of this
article, I suggested that we all made a choice to work in the field of sexual
violence prevention. I guess that means that we probably can’t, at this point,
change the nature of the work we do. Nor are we able to change the nature of
our clientele; at least, not without leaving the field.
At many of the workshops I do, I often ask
participants whether or not they work for an agency that has too much money or
too many staff. I’m never surprised by their answers. I also typically ask them
whether or not they feel like they have enough time in a day to do all the
things expected of them – either by superiors or their own work ethic. Workload
is a big factor. The more we do in a compacted work week, the less time we have
to step back and inoculate ourselves from the cumulative exposure to trauma
material. This can affect our relationships with co-workers, which can
sometimes lead to the “cubicle-effect” in which people keep their heads down,
working away in isolation and ultimately losing important social and cultural
contexts and opportunities present in the work environment.
Here
are some workplace risk factors to consider (see Pearlman & Caringi, 2009;
Pearlman & McKay, 2008):
- Role
ambiguity
- Role
conflict
- Availability
of tangible and intrinsic rewards
- Workload
- Recognition
that work is valuable
- Social
support
Over
the years, I’m moved away from direct service provision and more into
administration and consultation. As a worker, I knew all too well that there
were expectations on me and that there were minimum production quotas (e.g., three
psychotherapy clients a day, two groups a week, two assessments, etc.). I, too, worked in relative isolation
with little opportunity to debrief my work experiences with others. As an
administrator, I became keenly aware of the need for “real” supervision – not
the annual performance appraisal, but REAL supervision. Frankly, the last
performance appraisal I got was emailed to me by a supervisor who cared very
little for my experience of my job.
As a word, “supervision” connotes a certain
cringe-worthy experience. None of us like being informed of our faults, nor do
we like being told what to do. As such, it’s something of an unfortunate choice
of word and many of us may have experienced supervision as a chore. However, when
I say supervision here, I mean something wonderful – the opportunity to sit
down with someone who cares about you and the work you do enough to listen like
David Prescott, consider the information provided like Karl Hanson, and give
advice like Robin McGinnis. Supervision is the opportunity to share what you’re
proud of, as well as what causes you to quietly freak out. Regularly sharing
your work experiences with concerned peers or supervisors – either individually
or as a group – can have profound effects on quality of life, both
professionally and personally. And, we don’t do it often enough. Period.
Mitigation
Factors
Maintaining a balanced, self-determined
lifestyle is central to effective self-care. How well are you taking care of yourself? Of course, self-care needs
to be practiced in the workplace as much as in your personal life. We’ve seen
the effects of the holistic revolution in our treatment approaches with clients.
Why shouldn’t we also apply these ideas to aspects of our lives? The more
balanced we are across the full range of personal care, the more we are able to
cope with the stresses and demands that we will face in our admittedly very
challenging professional experiences.
People
are at less risk for burnout if they feel they have some degree of control or
influence over their work situation, believe that they are important enough to
be treated fairly, and value the work they do and are committed to it. We need
to create opportunities for
renewal, but this is a shared responsibility. We need to get out of our
cubicles and talk to one another! We need to recognize that when someone is
cooped-up in their cubicle that that’s a cause for concern and requires a
check-in.
“How are
you doing?”
“Is
everything OK?”
“Do you
want to come out for lunch with us?”
These
are the sorts of questions we owe to
ourselves and others to ask. It’s often been said that there is safety in
numbers, and there is a lot of truth to this when we think about how we can
lessen the negative effects of trauma we may experience as sexual violence
preventers.
If
you’ve been reading between the lines in this article, you may have noticed
that a lot of the concepts we apply to our clients who have sexually offended
may also hold some worth for us. Many of you will know that I have spent a lot
of time in my career working in a framework known as Circles of Support &
Accountability. One key idea behind CoSA is that “nobody does this alone” –
meaning that reintegration to the community after incarceration should not be a
solitary endeavor. I would extend the CoSA idea to other domains, including
high-risk professionals as noted above – that means us. We need a strong,
interactive, and reciprocal social support network to keep us on the right
track, too. So, look out for yourselves and your colleagues as you continue to
make society safer.
References:
Edmunds,
S.B. (1997). Impact: Working with sexual
abusers. Brandon, VT: Safer Society Press.
Ennis,
L. & Horne, S. (2003). Predicting psychological distress in sex offender
therapists. Sexual Abuse, 15,
149-157.
Leiter
M.P. & Maslach C. (2009). Banishing
burnout: Six strategies for improving your relationship with work. San
Francisco, CA: Jossey-Bass.
Mayo
Clinic (2012). Job burnout: how to spot
it and take action. Available at: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642
Pearlman,
L.A. & Caringi, J. (2009). Living and working self-reflectively to address
vicarious trauma. In C.A. Courtois & J.D. Ford (eds), Treating complex traumatic stress disorders: An evidence-based guide,
New York: The Guilford Press.
[1]Pearlman, L.A.
& McKay, L. (2008). Understanding and
addressing vicarious trauma: Online training module four. Pasadena, CA:
Headington Institute. Available at: http://www.headington-institute.org/files/vtmoduletemplate2_ready_v2_85791.pdf
[1] Laurie Anne Pearlman is a
powerhouse in the burnout and vicarious trauma research and practice world.
This online resource – and the others that go with it – is particularly
helpful. Visit http://www.headington-institute.org.
Utilizing Recreation Therapy as Part of the Treatment Model
Christin Santiago-Calling, CTRS Director of Recreation Therapy, The Whitney Academy
When we look at
the effects of trauma, neglect and abuse on adolescents, we see lasting and
pervasive effects. One of the largest
impacts tends to be in socialization, and the ability to form positive and
reciprocal relationships. Often, they struggle to build trust, have low
self-esteem, question their competence and see the world as a dangerous place;
all of which impede ones’ ability to build relationships. Many prefer social isolation as a coping
mechanism, though what they often desire most is social integration.
Although I will
go into more specifics later, the overarching theme in the literature is that
these negative experiences impact on the brain and greatly impede the ability of the traumatized
individual to control their arousal and behavior, which also greatly impacts
their ability to form relationships (Cohen, Perel, DeBellis, Friedman, &
Putnam, 2002).
As clinicians,
we are taught language-based methods to assist clients in dealing with the
effects of trauma, and ways to cope with stressors in an attempt to lead safer
and more productive lives. While these
methods may work for some individuals, research is finding that adolescents
especially, are responding more positively to body-based interventions, and
interventions utilizing Recreation Therapy (RT) techniques (Arai, Mock, & Gallant, 2012)
Recreation Therapy
Recreation
Therapy is a systematic process, which utilizes activity-based interventions
with the aim of improving the psychological and physical health of the
client. RT interventions are
goal-oriented, strengths-based and are whole-person centered, focusing on
improving the physical, emotional and psychological well-being of the
client. Interventions range from sports,
games, dance, music, drama, arts and work with animals. The main purpose of the activity is a
clinical goal, rather than pure enjoyment, which is what distinguishes RT interventions
from simple leisure activities.
RT
interventions may address many of the same clinical goals as traditional trauma
talk therapy, such as shame, guilt, emotional regulation, problem solving,
impulse control, self-worth, risk taking behaviors, executive functioning,
effective communication, stress reactions, competence and sensory
integration. An important difference
being that RT interventions are on the surface “just for fun”. This allows the
client to participate fully without feeling “assessed”, giving the clinician
greater insight into the client.
Brain Development Impairments
We know that
traumatized and neglected children suffer from deficits in brain
development. Studies have shown reduced
volume in the hippocampus, corpus callosum and cerebellum, as well as a smaller
prefrontal cortex, an overactive amygdala and abnormal levels of cortisol in
the brain (Perry, 2009)
These
impairments lead to decreased learning abilities, decreased ability to self-regulate
and soothe, reduced hemispheric integration, reduced motor coordination,
reduced executive functioning, reduced emotional and behavioral control, an
overreaction to stimuli and an abnormal reaction to stress (Perry, 2009)
Individuals who
have been traumatized may lack impulse control, and are often easily flooded,
vigilant and guarded, dysregulated behaviorally and emotionally, and struggle
with language-based instruction. They
tend to endorse low self-esteem and self-worth, hopeless and powerless, and may
exist in “survival mode” whereby they attempt to manage what they perceive to
be a very dangerous and threatening world (see van der Kolk, 2003).
Though these
brain deficits occur, given the brain’s plasticity, changes may occur with
intervention. Although there is no
evidence to date, this writer’s hypothesis is that RT interventions may work (in)directly
to repair and restore brain connections to overcome the effects of trauma.
Using RT Interventions to Address Brain
Deficits
Because RT
interventions are multi-sensory and body-based, they can be used effectively to
overcome deficits in brain development as a tool to manage responses to the
effects of trauma. RT interventions can
be designed to address the following objectives: hemispheric integration, sensory integration,
executive functioning, emotional and behavioral regulation, motor coordination
and situational responses to perceived stressors. This article will look at four RT activities,
which have been developed by the author, to illustrate the specifics of how such
interventions may impact and augment recovery from trauma.
Gotcha
A favorite
activity of adolescent clients is “Gotcha”.
The setup of “Gotcha” is as follows:
the group stands in a circle. The
facilitator prompts the group to place their right thumb (thumbs down) into the
open left palm of the person standing next to them, just touching the
palm. When the facilitator calls the
“magic number”, 3, all must pull their thumb away while grabbing the thumb that
is touching their own palm. The result
is the ultimate in multi-tasking, pulling your thumb while remembering to grab
the other thumb.
“Gotcha”
addresses multiple areas of deficit. The
most predominate is hemispheric integration.
Since the left and right hands of the clients are tasked with doing
different things, the activity increases connections between the left and right
hemispheres. Any activity that crosses
the midline of the body, works to enhance hemispheric integration, and
therefore increases the volume of the corpus callosum. Beyond this, executive functioning is
developed, through the ability to focus on the “magic number” and reacting
appropriately to it. Sensory
integration, specific to touch, is also an important part of this activity. The activity calls for the clients to touch
each other in safe, but unfamiliar ways, therefore allowing the clinician to
assess comfort with touch and safety with touch within their clients. Furthermore, this activity allows the client
to address motor control, as well as controlling arousal.
Up Chuck
The setup of
“Up Chuck” is as follows: the group
stands in a circle. The facilitator
empties a large bag of soft throwable toys (stuffed animals, soft rag balls,
stress balls, etc.) onto the floor and instructs each member of the group to
grab at least two items. One person
begins in the middle of the circle. The
facilitator instructs the group that on the “toss” command, the entire group
should toss their items into the air with the intent that the person in the
center of the circle can catch the items.
The person in the center is asked how many items they think they will
catch, and then asked if they are ready.
Once ready, the facilitator says, “one, two, three, toss”, and then the
group tosses their items toward the person in the center. After a few rounds of one person, add more
people to the center to catch items.
Within “Up
Chuck” many brain areas are being activated.
The most salient function is the sensory aspect to this game. Many of our clients have never had the
sensation of having safe and soft items fall all over them, similar to the
feeling of jumping into a ball pit. Many
clients who participate in this activity report feeling safe and secure as the
soft toys rain down upon them. Beyond
the sensory aspect of this game, the client has the opportunity to experiment
with various strategies to increase their success, allowing for creativity,
choice and safe failure. “Up Chuck” also
provides the client with the chance to increase motor control and how they use
their bodies in space, both of which can be areas of deficit with relation to
trauma and brain development. This is
often a new sensory experience for them, and assessing how they react to it is
a valuable tool for the clinician. Also,
this activity addresses making realistic or unrealistic goals and problem
solving strategies to meet those goals; and seeing what happens when we do not
meet our goals is valuable to the assessor as well. Watching the strategies of others that have
gone before, and evaluating their effectiveness is an executive function that
many of our clients lack, but one that is highly beneficial. Lastly, this activity allows those doing the
throwing to have a helper role to those in the middle. As a clinician, that is valuable information,
and it provides clinical direction and a framework for further discussions in
both individual and group work.
Human Pyramid Challenge
In “Human
Pyramid Challenge”, the group leaders instruct the group that they are tasked
with making as many human pyramids as possible within a given time frame (30
seconds). Give no time for questions or
strategies, and simply say, “ready, go” and watch your watch. With each human pyramid, the facilitator
should offer brief praise (yes!, nice!) and keep a count of each pyramid. Once they realize that any triangle they make
with their bodies count, the creativity ensues.
After the first 30 seconds, challenge them to beat their time and run
the activity again.
In “Human
Pyramid Challenge”, validation, problem solving, creativity and hemispheric
integration are the main drivers of this activity. Since the activity prompt is vague, it allows
for the clients to create their own version of what is meant by a “Human Pyramid”. And once the first is attempted and accepted
by the facilitator, it allows for more creativity and greater risk taking
within the bounds of what constitutes a human pyramid. Many of our clients externalize their treatment
success onto their clinicians, and look to us for the answers.
When presented with an ambiguous task, it often causes frustration and
anxiety initially. Again, this is an
excellent way to assess how clients handle those feelings, and what they do to
cope with, and overcome them. By
validating their efforts, they feel increased competence and confidence, which builds
self-worth. There is a measurable
difference in the demeanor before and after completing this activity (Barry
& Meisiek, 2010).
Have you Ever?
In “Have you
Ever?” each person in the group stands in a circle and is given something to
stand on (poly spots, pieces of paper, etc.).
The facilitator does not have anything to stand on. The facilitator tells the group that the game
is similar to “Musical Chairs” in that each person has a spot, except for one
person. The person in the middle asks a
question to the group, “Have you ever…” and fills in the blank with something
that they have done. The answer to their
own question must be yes, which will allow them to move. A “yes” answer to the question allows you to
leave your spot and find a new spot, a “no” answer allows you to stay on your
current spot. If a group member chooses
not to answer the question, they can just stay on their current spot. For example:
the person in the center of the circle asks the group, “Have you ever
eaten pizza?”, for those that have eaten pizza, they move from their spot and
find a new spot, those that have not eaten pizza stay put. The person that has no spot, is the new
person in the middle and asks a new question.
After a few rounds, challenge the group to ask clinically driven
questions.
“Have you Ever”
offers an activity with the potential for the most overt clinical application
for the client. Initially, the questions
posed are often superficial in nature, allowing for a sense of belonging and
normalcy. Once those feelings are
established, moving on to more clinically driven questions is highly
beneficial. Allowing clients to ask the
questions is a powerful way to derive what they are thinking and feeling based
on their own comfort. They have the
choices of what to ask, and more importantly, what to answer, in a
non-judgmental and non-confrontational manner.
Since answering the questions involves moving rather than speaking,
clients often feel freer to answer questions they might otherwise avoid. When questions are hard to come by or there
seems to be something being held back, the facilitator can find a spot to ask
the question of the group, which tends to open up a new direction of
questions. Clients typically really
enjoy this activity, and will often request to play it again and again.
Two adaptations
to this activity: take away one or more
spots to have multiple people in the center, and an “all answer”.
By taking away
one or more spots, it forces more than one person in the middle, and they must
find a question that they all can answer “yes” to. The adaptation builds commonalities, and
group development. Beyond that, it gets
them talking to each other about issues in a manner that is safe and
non-threatening.
An “all answer”
can be used when a question is too sensitive for the group members to answer in
the activity. Rather than move from
their spots, the person in the center calls for an “all answer”. When this is called, all group members turn
and face out the circle and put both hands behind the back, facing the person
in the center of the circle. If they
choose to answer “yes” to the question, they open one hand and keep one hand
closed in a fist. If they choose to
answer “no” to a question, they keep both hands closed in fists. This allows a safe way to answer more
sensitive questions.
RT at Whitney Academy
Whitney Academy
is a 50-bed residential treatment center for adolescent boys aged 10-22. There is a self-contained school and four
residences in the local community.
Clients at Whitney Academy are all dually diagnosed, have histories of
trauma/abuse/neglect and have a sexualized behavior problem.
At Whitney
Academy, RT is seen as one of the most important interventions in the
program. The RT program is used
throughout the Academy, across all disciplines.
During the school day, RT interventions are used in the classrooms, as
well as form the basis of the Physical Education program. Medically, RT interventions are often used to
assist with behavior regulation, weight management, sensory issues, and
treatment of various diagnoses (for example:
ADHD, depression, anxiety, ASD).
In the residences, RT interventions are used as part of the daily
schedule and routine. RT groups are held
daily, with community trips and life skill focused programming occurring on
weekends. Also within the RT program,
traditional sports are offered as part of Special Olympics of Massachusetts,
where RT principles guide the athletic team development, and are coached by RT
clinicians. Within the clinical
department, RT interventions are used as part of the clinical treatment model,
and RT staff often co-lead group therapy sessions. RT plays an integral role in meeting the
clinical, residential and academic needs of the clients at Whitney
Academy.
Important Factors for Successful RT
Interventions
Planning is the
single most important factor in using RT interventions. Plan for every possible outcome, and have
backup plans for your backup plans. Even
if most of the plans do not get used, having them will increase the confidence
of the facilitator, which will translate to the group. The more confident you, the facilitator feel,
the more safe the group will feel.
Understand the limits to what you can do with time, setting, and
equipment, and plan activities that can be done within those limits. Having a plan will help to avoid the biggest
threat to successful RT interventions:
helicopter facilitation.
When
facilitators do not feel confident in their abilities, or when they do not
trust their group, they tend to overcompensate and become helicopter
facilitators, who attempt to fix every problem, and create every solution. Effective facilitation allows for the group
members to dictate the direction and find their own solutions to problems. As clinicians, we tend to want to be leaders,
in RT interventions, we have to facilitate the learning, rather then teach
it. Allowing clients the freedom to make
choices, to take on leadership roles and problem solve on their own allows for increased
feelings of competence, which leads to increased confidence and
self-esteem. Their learning is
internalized to their own abilities and skills, rather than externalized to our
instructions. Things will go wrong, but
that is often where the learning occurs.
Allowing clients to fail in a safe environment, will foster a sense of
trust and allow for more risk taking within their clinical work. Connections that are made will be their
connections, and therefore have greater meaning to the client. Giving them the sense that you trust that
they will be safe and that they can handle these activities will be met with
the clients being safe and rising to the expectation.
This writer
proposes that effective use of RT interventions will lead to more effective
trauma work for both the client and the clinician. Goals will be achieved faster, and the work
will be deeper and more meaningful.
Adding one activity per group will lead to better buy in from the
clients, and more enjoyment from all involved.
Clients will look forward to the interventions, and will develop in ways
not seen in traditional clinical work; and, it is fun, and isn’t having fun
while doing our professional and clinical work a wonderful thing?
References
Arai, S. A., Mock,
S. E., & Gallant, K. A. (2011). Childhood traumas, mental health and
physical health in adulthood: testing physically active leisure as a buffer.
Leisure/Loisir 35(4), 407-422.
Butler, S.,
& Rohnke, K. (1995). Quicksilver:
Adventure Games, Initiative Problems, Trust Activities and a Guide to
Effective Leadership. Sage
Publications.
Cohen, J.,
Perel, J., DeBellis, M., Friedman, M., & Putnam, F. (2002). Treating
traumatized children: Clinical implications of the psychobiology of
posttraumatic stress disorder. Trauma,
Violence & Abuse, 3(2), 91-108. doi:10.1177/15248380020032001
Kraus, R.,
& Shank, J. (2010). Therapeutic Recreation Service: Principles and Practices. Wm. C. Brown Publishers.
Perry, B. (November
4, 2009). Understanding the Effects of Maltreatment on Brain Development. Child Welfare Information Gateway.
Rohnke, K.
(1984). Silver Bullets: A Guide to
Initiative Problems, Adventure Games and Trust Activities. Kendall/Hunt Publishing.
van der Kolk,
B. A. (2003). The neurobiology of childhood trauma and abuse. Child and adolescent psychiatric clinics of
North America, 12(2), 293-317.
About the Author
Christin
Santiago-Calling is a board certified Recreation Therapist, and is the Director
of Recreation Therapy for the Whitney Academy.
She has worked at Whitney Academy for 11 years, 8 of which have been in
the role as Director. As the Director of
Recreation Therapy, she has taken the department from a once per week group,
into the full department that now exists.
The RT department offers seven traditional sports, daily RT groups,
weekly community integration trips, weekly life skill groups, daily PE,
co-leading group therapy and social skills groups, and various weekly club
offerings.
Beyond her work
at Whitney Academy, Christin is also on the Board of Directors for the National
Adolescent Perpetration Network.
Christin has also presented her work at conferences throughout the US,
Canada, Sweden and England. She has done
consulting work to bring RT services to other organizations, as well as
utilizing RT interventions within various clinical and recreational
models.
Understanding and Preventing Adolescent Pedophilia TEDMED Talk
Elizabeth Letourneau
Please watch Dr. Elizabeth Letourneau deliver a powerful
message about youth who commit sexual abuse in the TEDMED talk (link below).
Many of you working in this area already know Elizabeth to be a passionate and
dedicated pioneer in the prevention of child sexual abuse, and in this video
you see her educate, narrate, and advocate in a way that can make all of us
proud to do this work. Elizabeth provides clear explanations of basic research
on youth who have sexually offended. She delivers compelling arguments against
problematic policy, while providing a new way of understanding child sexual
abuse through a public health lens. Finally, she shares her own learning and
subsequent work with non-offending youth to make the case for prevention, not
punishment, as our response to this issue.
Step One of Cultural Competency Addressing Privilege & Power
Cordelia Anderson
Note to readers: This article by Cordelia builds upon and adds to the blog post by Kieran McCartan and David Prescott, “Race, culture, community & abuse”.
A related event, "Dismantling Racism: The Relevance to Prevention," will be held at this year's ATSA Conference on Thursday, October 26, 2017 from 5:30 to 6:30 pm at the Sheraton Kansas City Hotel at Crown Center, in Kansas City, Missouri. If you are in the area, we welcome you to attend the event and join the conversation.
Child sexual abuse, sexual violence and pornography are not easy topics to talk about, but in my experience raising questions related to power, privilege and race are even tougher. Just like trying to talk about “sex offenders”, invitations to talk about such difficult topics often results in defensive, protective, ambivalent, or even angry responses. Most organizations who work with victims and survivors are raising these difficult questions. In fact, most of my thinking related to power, privilege and what’s all involved in cultural competency, I have learned from and with those who work with survivors/victims, and with those who work on social justice as part of prevention.
However, I wonder how the sensitive but pervasive issues related to our own sense of power, race, class, and disabilities translate into the work of treating and researching those who sexually offend. As a member of the ATSA Prevention Committee, I am hoping our entire organization will grapple with how this all fits within the priorities and engage in these discussions. I am writing this blog as an invitation to further conversations and perhaps more attention to this in your practice, your research and in discussions at our conferences.
Questions to consider include:
-
Are White/Caucasian professionals sensitive to the unique experiences of clients who are people of color? Or, what it is like for professionals in the field who are people of color who work in dominantly White organizations?
-
Do White/Caucasian professionals recognize limits to their understanding of ways clients of color experience prejudices across settings, including in our own offices?
-
Do we as White/Caucasian professional spend time reflecting on our own power and privilege and how this influences the personal and professional decisions we make?
We know that sexual abuse thrives in secrecy and shame. For years, our organization and our practices might have reflected the isolation of the very issue we have been working on. More recently, we have begun to also understand the need for increasing cultural competency. However, if we expand our vision even further, we will see that there are tensions between the focus on cultural competency versus racial justice. At the core of that difference is our need to not only learn more about the individuals we work with but to begin to address our individual and collective privileges as professionals that do this work. We have made a commitment to healing and to minimize the harm that has been done. But what if we are also, unintentionally increasing the harm?
Therapists and advocates appreciate the importance of dealing with the whole person, their family and community of support to address the presenting problem or issue. Those who do prevention work know the importance of expanding that view even further to also address the environment and social norms that create families, communities, organizations and societies where harm is likely to develop and continue.
The issues we work with are complex enough that the tendency is to say we cannot afford to further muddy the waters by addressing race, power and privilege. Or we may say that there are more pressing issues in the work we do in terms of community safety.
I’ve been at this work for over 40 years and in the time I have left, I hope to engage in meaningful conversations with colleagues and organizations that I care deeply about in ways that address the intersections of these issues. I believe the first step toward cultural competency and a social justice framework is to more fully and intentionally face my white privilege and the norms of institutional and systemic white supremacy. It is not comfortable to talk about or easy work to do but it is essential. One example of the work in this area that’s underway is the 2018 theme of the MASOC/MATSA’s conference which is cultural competency.
Since first writing this blog in May, and then holding off on submitting it until closer to the ATSA conference, there has been so much happening in this country and around the world that raises the urgency of engaging in these discussions and taking appropriate action. With such challenging issues, it can be helpful to consider actions we can actually take. We can:
- Commit to meaningful – though often uncomfortable – conversations about our own privilege and power.
- Commit to on-going learning about how such power and privilege affects the effectiveness of our work and quality of our relationships.
- Intentionally address power and privilege when creating goals for our own work and the goals of our clients.
I am writing with great humility about my own limitations related to all of this. I know likely I have I stepped in it in one way or another. Still, I believe the risk is worth it to get more meaningful conversations on this topic going and to revisit ATSA’s role. I believe it is an opportune time for ATSA to do even more with these conversations and related actions. The ATSA Prevention Committee is hosting a panel related to how these issues fit with prevention. It will be on Thursday, October, 26, from 5-6. We hope you can attend, read some of the writings below and/or find other ways to engage further in this work.
For those interested in this topic these readings may be of interest:
Say the Wrong Thing: Stories and Strategies for Racial Justice and Authentic Community, by Dr. Amanda Kemp, Lisa Graustein, June 16, 2016,
This article was adapted from a post on the ATSA Blog. View the original post.
Read the related blog post “Race, Culture, Community & Abuse” by Kieran McCartan and David Prescott.
Assessment of Deviant Preferences Using Novel Behavioral Assessment Procedures
John Michael Falligant, M.S. Department of Psychology, Auburn University
Recently, I was
fortunate to be awarded a Predoctoral Research Grant from ATSA to fund an
exciting new project, “Assessment of deviant preferences using novel behavioral
assessment procedures.” Broadly, my research interests include the assessment
and treatment of illegal sexual behavior (ISB) and severe problem behavior among
adolescents adjudicated for ISB, traumatic stress, delay and probability
discounting, legal decision-making strategies, and behavior analysis. This new
project will encompass many of these research areas, as I hope to evaluate the
utility of several novel behavioral assessment procedures to assess
inappropriate preferences for deviant visual stimuli among adjudicated youth.
Although many
contextual developmental factors, such as social skills deficits, lack of
supervision, and impulsivity contribute to the development or maintenance of
ISB among juveniles (e.g., Chaffin, 2008), inappropriate sexual interests may
also be a contributing factor for some adolescent offenders. Given that
juveniles who engage in illegal sexual behavior are more likely to offend
against children than adults (Finkelhor, Ormrod, & Chaffin, 2009), it may
be necessary that clinicians evaluate these individuals’ preferences for
inappropriate sexual partners in addition to assessing all other critical
contextual factors that are related to adolescent offending. Thus, identifying
procedures to assess preferences for inappropriate sexual partners is a crucial
step towards adequate treatment and assessment of recidivism risk for these
youth. Unfortunately, there are relatively few reliable and valid objective
procedures available to assess sexual preference for juveniles relative to
adult offenders. For example, phallometric assessment, which is considered a
very good measure of deviant sexual arousal (e.g., Letourneau, 2002), is largely
viewed as inappropriate for juvenile populations because of the lack of
evidence of its reliability and validity with adolescents (e.g., Kaemingk,
Koselka, Becker, & Kaplan, 1995) and because of the obvious ethical
concerns associated with using this procedures with juveniles (Worling, 2006).
In contrast to phallometric assessments, viewing time (VT) procedures have
emerged as a less-intrusive alternative to assess preferences for deviant
sexual stimuli. Though both VT and penile plethysmograph may accurately
identify deviant preferences in adult offenders (Letourneau, 2002), the use of
VT-based procedures is largely unsupported with adolescents (Smith &
Fisher, 1999). Accordingly, few options remain for assessment of deviant sexual
interests in adolescents apart from self-report measures, which have numerous
drawbacks (e.g., Gannon, Keown, & Polaschek, 2007; Rea, Dixon, &
Zettle, 2014).
Fortunately,
translational behavioral research may hold the key to improving assessment
procedures concerning juvenile offenders and deviant sexual stimuli.
Specifically, research involving conjugate schedules of reinforcement suggests
that objective, behavioral measures of deviant sexual arousal may be attainable
for adolescents. Conjugate schedules of reinforcement have garnered increased
attention recently for their roles in a wide variety of complex behavior (e.g.,
MacAleese, Ghezzi, & Rapp, 2015; Rapp, 2008). In conjugate schedules, the
schedule of reinforcement is continuous, and the rate or intensity of the reinforcer
is proportional to one or more dimensions of the target response (e.g., Rapp,
2008). Pressing the accelerator on a car is one example of conjugate
reinforcement, as there is a proportional relation between the magnitude of the
target response (i.e., applying strong pressure to accelerator) and the
reinforcing event (i.e., rapidly accelerating). The more force that one applies
to the accelerator, the faster the vehicle accelerates. This is in contrast to
discrete schedules, under which there is no proportional relationship between
responses and reinforcers (e.g., regardless of how much force is applied to the
accelerator, the vehicle always accelerates at the same rate).
In contrast to assessment
procedures that use discrete schedules of reinforcement, conjugate schedules
provide a dynamic mechanism for understanding response-reinforcer relationships
(see Rapp, 2008 for an overview). Recently, MacAleese et
al. (2015) demonstrated that changes in clarity of a preferred visual stimulus
can effectively be used in a conjugate-reinforcement experimental preparation.
Importantly, this unique procedure allows clinicians and researchers to
systematically assess whether stimuli that participants report are
highly-preferred are actually appetitive. Conversely, this procedure may allow
clinicians to test whether stimuli (e.g., pictures of young children vs.
peer-aged individuals) that are reported to be non-preferred or punishing are
actually non-preferred/punishing. That is, clinicians may be able to measure
the degree to which deviant and/or non-deviant visual stimuli (e.g., pictures
of age-appropriate peers, pictures of young children, pictures of non-evocative
stimuli) are appetitive without many of the drawbacks, such as obvious demand
characteristics, associated with other procedures used to evaluate preferences
for appropriate/inappropriate stimuli with juveniles (i.e., self-report
measures, VT procedures). There are numerous advantages to using this or
similar conjugate-reinforcement procedures to assess for deviant preferences
with juvenile offenders. First, these computer-based procedures generate
numerous dependent variables, such as the
number of responses, the duration of the responses, and the time in the
sessions when the responses end, all of which may be modeled as behavioral
indices of preference. Furthermore, other apparatus may be used
in these conjugate preparations such as force transducers, which can generate
the aforementioned dependent variables in addition to the maximal peak force in grams of each response. This is stark
contrast to data produced from VT procedures, which only include the duration
that each stimulus is viewed and is a relatively insensitive, passive measure
of preference (e.g., Letourneau, 2002). Additionally, these type of conjugate
schedule procedures lack many of the demand characteristics associated with VT
procedures (Smith & Fisher, 1999), potentially making these procedures more
discrete and less prone to impression management (Gannon et al., 2007).
Overall, in the current project I will assess
the utility and application of several conjugate-reinforcement based assessment
procedure for measuring deviant preferences with juveniles adjudicated for illegal
sexual behavior in a secure residential facility. Using a computer-based
force-transducer procedure with audiovisual stimuli, the study aims to
establish the convergent validity and reliability of these procedures using
available data regarding participants’ offense characteristics and a variety of
established risk assessment tools and protocols. The current study
will be unique in several aspects. For example, there is a paucity of research
on the development of behaviorally based assessment procedures for deviant
sexual preferences, and the current study will utilize a heterogeneous
population of juvenile delinquents, including those receiving mandatory
inpatient treatment for ISB. Thus, the current study has the potential to
develop novel assessment procedures that hold important applied and
translational implications for researchers and clinicians interested in the
assessment of risk for re-offending. If you would like more information about
this project, please send me an e-mail at jmf0031@auburn.edu. I would also like
to recognize and thank my project advisors, Drs. John Rapp and Barry Burkhart. This
project would not be possible without the generous financial support offered by
ATSA through the Predoctoral Research Grant.
References
Chaffin,
M. (2008). Our minds are made up—Don't confuse us with the facts: Commentary on
policies concerning children with sexual behavior problems and juvenile sex
offenders. Child Maltreatment, 13, 110-121.
Finkelhor,
D., Ormrod, R., & Chaffin, M. (2009). Juveniles who commit sex offenses
against minors. Juvenile Justice Bulletin. Washington, DC: US Government
Printing Office.
Gannon,
T. A., Keown, K., & Polaschek, D. L. (2007). Increasing honest responding
on cognitive distortions in child molesters: The bogus pipeline revisited. Sexual
Abuse: A Journal of Research and Treatment, 19, 5-22.
Kaemingk,
K. L., Koselka, M., Becker, J. V., & Kaplan, M. S. (1995). Age and
adolescent sexual offender arousal. Sexual Abuse: A Journal of Research and
Treatment, 7, 249-257.
Letourneau,
E. J. (2002). A comparison of objective measures of sexual arousal and
interest: Visual reaction time and penile plethysmography. Sexual Abuse: A
Journal of Research and Treatment, 14, 203-219.
MacAleese, K. R., Ghezzi, P. M., & Rapp,
J. T. (2015). Revisiting conjugate schedules. Journal of the Experimental
Analysis of Behavior, 104, 63-73.
Rapp, J. T. (2008). Conjugate reinforcement:
A brief review and suggestions for applications to the assessment of
automatically reinforced behavior. Behavioral Interventions, 23,
113-136.
Rea,
J. A., Dixon, M. R., & Zettle, R. D. (2014). Assessing the Generalization
of relapse-prevention behaviors of sexual offenders diagnosed with an
intellectual disability. Behavior Modification, 38, 25-44.
Smith,
G., & Fischer, L. (1999). Assessment of juvenile sexual offenders:
Reliability and validity of the Abel Assessment for Interest in Paraphilias. Sexual
Abuse: A Journal of Research and Treatment, 11, 207-216.
Worling,
J. R. (2006). Assessing sexual arousal with adolescent males who have offended
sexually: Self-report and unobtrusively measured viewing time. Sexual Abuse:
A Journal of Research and Treatment, 18, 383-400.
A Student’s Guide to the ATSA 2017 Conference
Andrew E. Brankley Ryerson University, Toronto, Canada ATSA Student Representative on the Board of Directors
FO·MO /ˈfōmō/
Origin – English “fear of missing out”
Noun
informal
Anxiety
that an exciting or interesting event may currently be happening elsewhere.
“My FOMO
is bad because I don’t know what to do at the ATSA 2017 Conference!”
The opportunities at ATSA Conferences can seem
overwhelming—especially for students. From the start you are handed a thick
package of information about concurrent sessions, plenaries, receptions, and
other events where you can learn, share your interests, and meet colleagues and
leaders in the field. With so many options you feel burdened with the tyranny
of choice - Where do you go?
The purpose of this guide is to direct students’
attention towards events that are either specially designed for students or are
cornerstone events that should not be missed at any ATSA conference (See Table
1 for an outline).
5 Tips for
Before you Arrive
Think of conferences like major theme parks that deliver
knowledge and collegiality instead of screams and disappointing/overpriced
food. There are a few common practices that can help you get the most out of
your day:
(1) Pack clothes that are professional, yet
comfortable. Conference days are long and there are few things
worse than painful shoes or poorly fitting clothes cramping your discussions
and networking.
(2) Give yourself a travel day. Conferences
are intense. Try booking an extra day on either end to give you a chance to
acclimate before and rest afterwards, even stealing a few moments to have a
look around Kansas City.
(3) If you bring a day bag, pack light
(same reasons as Tip 1).
(4) Include in your day bag some “just in case” items.Prepare for a rainy day. These can include
over-the-counter analgesics for headaches, Tide-to-go pens for stains, and mints
for awkward bad breath.
(5) Download the Conference App. This
little treasure not only contains maps, schedules, and abstracts, but it is
also a great way to connect with people.
(6) Stretch your Twitter Thumbs. Twitter
has become the dominant social media platform to quickly connect and
disseminate information about conferences. I personally enjoy it because it
helps me stay engaged with presenters as I am listening to find the next quote
to post.
Table 1. A Student’s Guide to Student-Focused and
Recommended Events
(click on the table to view a larger version)
Preparing
the Next Gen – Wednesday
Hosted by
Andrew Brankley & Sacha Maimone
Before the conference begins check out the only free
preconference workshop that is designed especially for students eager to get
the most out of ATSA and their training experiences. The focus of this workshop
is developing professional skills critical to a successful career. The three
areas of professional growth are (1) constructing a professional identity, (2)
networking and self–promotion, and (3) improving self–care. Presenters will use
a combination of lecture, demonstration, group activity, discussion, and
detailed resource material to actively engage and inform audience members. the
goal of this workshop is to provide a comfortable environment for students and early career professionals to
learn, share ideas, and network.
Student Clinical Case and Data Blitz – Thursday
Hosted by Danielle Loney & Mina Ratkalkar
The Student Clinical Case and
Data Blitz caps off the first conference day, just before going to the poster
session. The Blitz features 14 presentations
examining important issues related to the prevention, assessment, management,
and treatment of individuals who engage in nonconsensual sexual behaviours. Even
if you are not presenting, you should come and hear these rapid 5-minute
presentations from upcoming researchers and professionals. This year promises
to be the best yet as we received more submissions than ever before
Poster Session – Thursday/Friday
Overseeing Student Poster Awards, Carissa Toop
Just after the Blitz
on Thursday, and again on Friday, is the Poster Session. Do not let the name
fool you—student content dominates the poster session. The content is so good
we have a tradition of awarding prizes for the top student posters for
each day. Posters will be evaluated on their visual presentation and quality of
research. So come by and check out the stellar posters while taking advantage
of the hors d'oeuvres and cash bar.
Next
Generation Reception – Thursday
Hosted by
Andrew Brankley & Carisa Collins
Your first conference day is still not finished as we
invite you to The NextGen Student Reception. The reception is a “backstage
pass” designed to connect ATSA student members with leaders in our field. You
enter a comfortable, social environment where students can network and engage
established researchers in the field of sexual abuse in lively conversation to
discuss issues and ask questions. This is especially important for students
planning on graduate school. We invite the ATSA Lifetime Achievement Award
winner to give a few words of wisdom and, new this year, will be networking
games with prizes for the winners.
Recommended
Events
The ATSA conference has several not-to-be missed
events that are great opportunities for students to mix with ATSA membership.
The morning network events are hidden gems as you have the opportunity to meet
people interested in meeting you. I also cannot say enough good things about
the annual Speakers Event. Picture private Cirque Du Soleil-style performances,
Mexican food and dancing, and go kart racing. These events are so popular that
back channel competitions are held to secure the few leftover tickets, or so I
am told.
The Annual ATSA conference is the highlight of my
professional and social calendar. I praise it so highly because I have been to
many other conferences and I have yet to see such a genuine combination of quality
learning and professional socializing. Whether you are presenting or listening,
ATSA is a supportive nurturing environment. Don’t miss out!
Authors Note: I would like to thank the members of the
student committee for their help and input in writing this piece: Carisa
Collins, Carissa Toop, Danielle Loney, Darragh McCashin, Ian McPhail, Jacinta
Cording, Kelcey Puszkiewicz, Laura Kuhle, Sacha Maimone, Mina Ratkalkar
Register for the 2017 ATSA Conference
RNR Principles in Practice In the Management and Treatment of Sexual Abusers
Review by David S. Prescott, LICSW
By Sandy Jung, Phd,
RPsych
Safer Society Press,
Brandon, VT
https://www.safersociety.org/press/store/
ISBN 978-194023407-6
174 pages, $30.00
David S. Prescott, LICSW
Forum Book Review Editor
|
Who knew that three simple principles could be so difficult
to understand and implement? They exist at the center of roughly four decades
of research and practice around the world. In brief, the risk principle holds that the most intensive interventions should
be reserved for those who pose the highest risk for re-offense. The need principle holds that interventions
should target those treatment needs associated through research with re-offense
risk. The responsivity principle
holds that interventions should be provided in accordance with the individual
characteristics of each treatment participant.
As Jung quickly points out in the first pages, it can be
easy to look backwards at the principles and the research that supports them, and
conclude that they are inherently obvious while wondering why anyone would have
ever thought differently. She then lays out an excellent case for why this sort
of retrospective bias would be wrong. Starting with the tragically misguided
conclusions of Martinson (1974), Jung walks the reader through the origins of
what is now known simply as “RNR”.
Why is this important? From an empirical perspective, it is
vital, since Hanson, Bourgon, Helmus, & Hodgins (2009) found that these
principles apply as much to people who have sexually abused as to any other
person who comes into contact with the criminal justice system. It is equally
vital from a practical standpoint when one considers how difficult these
principles can actually be to understand and implement. Consider the furor in the
wake of Hanson and Bussiere’s (1998) meta-analysis finding that denying one’s
offense is not a risk factor on its own. Much debate ensued (e.g., Lund, 2000),
with many coming to conclude that denial should likely be considered a
responsivity factor. Indeed, Jill Levenson and the author conducted three
consumer satisfaction studies in which the belief of treatment participants was
clear: being accountable for one’s actions was the most important part of
treatment (Levenson & Prescott, 2009; Levenson, Prescott, & D’Amora,
2010; Levenson, Prescott, & Jumper, 2014). Similarly, consider the plight
of self-esteem in treatment. Scant research shows it to be a risk factor, and
yet it can be vital to meaningful engagement in treatment.
Jung’s is among the first books to take on the RNR
principles and their place in treatment specifically with people who sexually
abuse (Looman and Abracen’s 2016 book also addressed RNR, although theirs was
focused exclusively on treating those who pose the highest risk). Compared to
other writings in this area, it is presented with refreshing clarity and
elegance. This is particularly welcome, as many readers have – frankly –
criticized the original books by Don Andrews and Jim Bonta as being difficult
to read. It has often seemed that while most professionals want to have read
authoritative works about RNR, few actually want to go through the process of
reading them. With this effort, Sandy Jung has made these principles
significantly accessible. When reflecting on their earlier efforts, it is
equally clear that Safer Society has “upped their game” in terms of production
values.
The chapters each come with examples, bullet points of
important concepts, and summaries of key points. Readers should not be fooled
by the simple language: Jung has distilled this material only after years of
study and work with these principles. After an abridged history of RNR, Jung
discusses what the principles are and are not. She next reviews why they are
important to consider, how they contribute to overall program efficiency, how
programs can maintain adherence to them, and why a book on them is necessary in
the first place.
Jung next takes each principle in its turn, from risk
assessment to distinguishing between general and specific responsivity and key
factors to consider in all three principles. These chapters will be helpful to
novices and more seasoned readers alike. A chapter of case illustrations
follows, followed by an exploration of implementation challenges; as pristine
as the principles can appear in print, they still require fallible humans to
put into practice. To this end, Jung’s efforts reflect very considerable
experience.
The production, clarity, and importance of the topic make
this a welcome and necessary addition to our field’s knowledge and practice. While
Sandy has publicly commented on the amount of work involved in producing a
volume of this sort, the field owes her a debt of gratitude. Here’s hoping that
we hear from her again soon.
References
Hanson, R.K., & Bussiere, M.T. (1998).
Predicting relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical
Psychology, 66, 348-362.
Hanson, R.K., Bourgon, G. Helmus, L., & Hodgson, S. (2009).
The principles of effective correctional treatment also apply to sexual
offenders: A meta-analysis. Criminal Justice and Behavior, 36, 865-891.
Levenson, J.S., &
Prescott, D.S. (2009). Treatment experiences of civilly committed sex
offenders: A consumer satisfaction survey. Sexual Abuse: A Journal of
Research and Treatment, 21, 6-20.
Levenson, J.S.,
Prescott, D.S., & D’Amora, D.A. (2010). Sex offender treatment: Consumer
satisfaction and engagement in therapy. International Journal of Offender
Therapy and Comparative Criminology, 54, 307-326.
Levenson, J.S., Prescott,
D.S., & Jumper, S. (2014). A consumer satisfaction survey of civilly
committed sex offenders in Illinois.
International Journal of Offender Therapy and Comparative Criminology, 58,
474-495.
2017 ATSA Conference Events
ATSA Gives Back
Tuesday, October 24, 11:30 am - 3:30 pm
During ATSA’s first corporate social responsibility
event, a new half-day pre-conference activity, you will have the opportunity to give back to our
host community by helping a local non–profit. The 2017 recipient is
Sunflower House, an organization that assists children who have been
physically and sexually abused. We will be providing a range of services from helping clean and organize the interior to doing some exterior
landscaping, to stuffing envelopes, to organizing bags and toys for
the children. There’s a project for everyone’s interest. enjoy a day of
exercise and camaraderie as you help make life better for children.
there is limited space available, so sign–up today with on your online
registration! for more information contact Ann Snyder, ATSA Public
Affairs Coordinator: ann@atsa.com
Public Engagement Event
Tuesday, October 24, 6:30 pm - 8:00 pm
This event brings together community members, professionals,
practitioners, academics, and researchers to have a frank and informative
discussion about preventing sexual harm. this discussion will be led by
experts in the field around residency restrictions, sex trafficking, youth
registration and campus sexual assault. Everyone is welcome!
Morning Networking Event
7:45 am – 8:15 am | Wednesday, Thursday, Friday
Back by popular demand! Start your morning
off with a brief networking experience sure to put a
smile on your face. Some of the most memorable
and valuable opportunities at a conference come
from the people you meet, so join us for a 30 minute
networking event to broaden your professional circle.
Experience a new approach to networking, meet
some new colleagues, and possibly win one of our
wonderful door prizes! Great for those new to the
ATSA conference as well as long–time members.
Registration not required.
Dismantling Racism: The Relevance to Prevention
Thursday, October 26, 5:30 pm - 6:30 pm
Talking about sexual abuse and violence may seem easy
compared to talking about race, power and privilege. Yet
facing this discomfort is necessary to understand how the
biases we all have can get in the way of positive use of the
privileges and power we have along with our ability to build
authentic relationships. Join us for this unique and thought–
provoking discussion.
Download the full listing of ATSA Conference Events.
Download the 2017 Conference Brochure.
Preventing Harmful Sexual Behaviors in Youth: An Infographic from the ATSA Prevention Committee
Every child and adolescent who engages in harmful sexual behaviors does not have the same motivations, risks, strengths and skills. They face different risks, they have different histories, and therefore their need for support systems will be different. A “one size fits all” intervention will not work for every child and teen. Our support and education must be individualized for each child.
To download your own copy to share please visit: www.atsa.com/infographic
Welcome Incoming Board Members
Congratulations to our newly elected and appointed Board Members.
Tyffani Monford Dent, Psy.D.
Cleveland, Ohio
At-Large Representative
2018-2020 |
Katherine Gotch
Portland, Oregon
Public Policy Representative
2017-2018 |
Alison Hall
Pittsburgh, Pennsylvania
Prevention Representative
2018-2020 |
Kevin L. Nunes, Ph.D.
Ottawa, Ontario, Canada
Education and Training Representative
2018-2020 |
Steve Sawyer, M.S.S.W.
White Bear Lake, Minnesota
Chapter Engagement and Development Representative
2018-202020 |
Anita Schlank, Ph.D., A.B.P.P.
Burkeville, Virginia
Adult Clinical Practice Representative
2017-2019 |
To nominate yourself or a colleague for the ATSA Board, submit your nominations beginning in March, 2018.
The following positions will be available for nomination for the 2019 Election:
- President-Elect
- Research Representative
- Public Policy Representative
- At-Large Representative
2017 ATSA Awards
In recognition of researchers and clinicians who have made significant contributions to our mission and to the prevention of sexual violence through research, treatment, and management, the ATSA Board of Directors is pleased to announce this year’s award recipients.
Lifetime Significant Achievement Awards
ATSA is proud to present Grant Harris, Ph.D. and Marnie Rice, Ph.D. with posthumous Lifetime Significant Achievement Awards.
Grant Harris (1950–2014) and Marnie Rice (1948–2015) were pioneers in the
development and evaluation of sex offender treatment programs, appraising the risk of
sexual and violent re-offending, the assessment of sexual preferences, and developing
theories to explain sexual offending. In terms of the criteria for the award, they made
important contributions to the state of knowledge of sexual abuse, the reduction or
prevention of sexual abuse, and the development of programs to assist abusers.
Gail Burns–Smith Award
Patty Wetterling
Patty Wetterling is a nationally recognized educator on the issues of child abduction and sexual exploitation of children. Patty and her husband Jerry, co–founded the Jacob Wetterling Resource Center (JWRC) to educate communities about child safety issues in order to prevent child exploitation and abductions. Patty co–founded and is past Director of Team H.O.P.E. a national support group for families of missing children. She is also a founding member and past president of the Board of Directors of the Association of Missing and Exploited Children’s Organizations (AMECO). She has also co–authored a book, “When Your Child is Missing: A Family Survival Guide,” along with four other families. For nearly 27 years Patty has been a visible spokesperson effective public policy and importance of keeping hope alive.
Distinguished Contribution Award
Ret. Det. Robert A. Shilling, A.A., ATSA-F
Detective Bob Shilling is known
internationally for his expertise in tracking
down individuals who have sexually abused
children. He has written or co–authored
numerous laws to help protect children and
has become one of the world’s most sought–
after experts in catching individuals who
sexually offend against children.
For the majority of his 32–year career,
he has served in the Seattle Police
Department's Sexual Assault and Child
Abuse Unit. During that time, he was
invited by Interpol to serve a special three–
year assignment beginning in 2012 to lead
their Crimes Against Children Group,
the first time in Interpol history that a
municipal–level police detective
and an American has filled this
highly distinguished position. In
that role, he coordinated efforts
for the agency’s 190 member
countries and implemented
best practices globally.
He continues to work with the
Seattle Police Department
and consult with Interpol. “My
passport is very full," the 61–year–
old grandfather of three says of
his travels to France, Germany,
Switzerland, the U.K., Italy, Sri
Lanka, Thailand, and the island of
Mallorca, all on Interpol business.
2017 Student Awards Recipients
Graduate Research Award
Lesleigh Pullman, Ph.D. Candidate
Differences between Biological and Sociolegal Incest Offenders: A Meta-Analysis
Pre-Doctoral Research Grant
Maddison Schiafo, M.A.
Personality, Decision-Making, and Sexually Coercive Behaviors among College Students
Pre-Doctoral Research Grant
Natalie Germann, Ph.D. Student
Sexual Violence Prevention: The Development an Integrative Psychometric Tool to Evaluate
Outcomes of Sexual Violence Primary Prevention Programmes in High-School Populations
Pre-Doctoral Research Grant
Nicole Graham, M.S.
Examining the Use of Hebephilia and Paraphilia Non-Consent in Sexually Violent
Predator (SVP) Evaluations
ATSA Professional Code of Ethics 2017 Revisions and Additions
Becky Palmer, MS Past Ethics Chair and Current Committee Member
The arduous task of revising
and updating the ATSA Code of Ethics (COE) has been completed. The rigorous
review and input by all committee members has helped shape this updated
version. The COE are currently at the printer, likely by the time you receive
this article you will have access to the updated version.
Ethics by definition are moral
principles that govern a person’s or group’s behavior. Our hope is that each of
you will make it your personal and professional responsibility to review our 2017
COE. While implicit and at times explicit within the revised document you will
find encouragement to seek peer or professional consultation, it’s always a
helpful reminder that we alone do not possess all of the answers to any
question or dilemma we may face in our professional lives. Thankfully we have
many caring and brilliant colleagues who are more than willing to talk through
any ethical questions you may have. The committee also encourages you to reach
out before your situation becomes a “sticky wicket”.
Of course as anyone who has
spent time writing professional guidelines, standards or codes of ethics can
tell you, expect to spend time discussing the occasions of when to use
shall-will, should-would, and may-can. So, yes we did spend some time having
robust discussions on the proper word usage but you may not notice them
throughout the updated document. The
ATSA Ethics Committee hopes that each Member will find this updated version of
our COE to be a helpful resource and provide some direction when faced with
potential ethical questions.
Our COE is divided into two
sections: Section A) Ethical Principles
and Section B) Rules and Procedures.
Of note our COE is meant to complement ATSA Practice Guidelines for Male
Adults.
In Definitions you will notice that the definition of client has been
enhanced to identify that a client is not just a person, but rather with the
increasing trend of courts and agencies paying for treatment and assessments it
is important to remember that we have a professional responsibility to
referring agents as well.
Professional
Conduct
The additional points for this
section of the COE will be noted as k) ATSA may consider deviations from the
ATSA Adult Practice Guidelines and ATSA Adolescent Practice Guidelines an
ethics violation except to the extent that a guideline conflicts with
applicable laws or professional regulations that pertain to a Member’s practice.
Also of note is the addition of l) It is unethical for ATSA Members to conduct
evaluations with the primary purpose of determining guilt or innocence.
We
updated the professional conduct section to include sexual orientation as a
part of sexual harassment and so it is not gender specific.
(e)
Members shall not engage in sexual harassment. Sexual harassment is unlawful
discrimination within a professional relationship on the basis of gender and/or
sexual orientation and includes any unwelcome verbal or physical sexually
oriented conduct that is sufficiently severe or pervasive to have the purpose
or effect of unreasonably interfering with a professional relationship or
creating a hostile, intimidating, or offensive professional environment.
The
standard for determining whether harassment based on an individual’s gender
and/or sexual orientation is sufficiently severe or pervasive to create a
hostile, intimidating, or offensive professional environment is whether a
reasonable person in the circumstances of the complaining individual would so
perceive it.
Payment for Services
Bartering
for services may result in a dual relationship and therefore may leave a Member
open to an ethical complaint. Members should conform to their specific
professional discipline’s codes of ethics for further guidance (e.g., the
Canadian Psychological Association or American Psychological Association). For
further discussion of dual relationships, see Section 8, Dual Relationships.
An
addition to this section of the COE is: Members shall address the following
financial matters with clients: i. The Member shall describe the fees for
services to the client either before or at the time of the initial appointment.
ii. The Member shall settle payment arrangements for fees at the beginning of
an assessment or a therapeutic relationship. iii. If there is a change in fees,
or if a service is to be provided for which the fees have not been discussed,
the Member shall inform the client of the change in fees before providing the
service. In the case of an emergency, the Member shall inform the client of any
fees as soon as is practical after rendering the service. iv. If the client is
a minor or lacks the capacity for consent, the Member shall inform the parent
or legal guardian of all fees in the manner outlined above. This has been
removed from the client relationships section.
Promoting
professional obligations you will notice the following inclusions under Client
Relationships. (j) If Members anticipate the termination or disruption of services
to a client, they shall notify the client promptly and, when possible, provide
for transfer or referral to a different practitioner.
(k)
Members who serve a client of a colleague during a temporary absence or
emergency shall serve that client with the same consideration they afford to
their own clients.
(l) Members recognize that their primary
professional obligation is to the client to whom they are providing services,
regardless of who is paying for those services. Additionally, Members recognize
that third-party relationships have the potential to create conflicts of
interest and that the primary professional obligation remains to the client.
(m)
When performing consulting services, the client may be an agency or
organization. In this case, Members shall behave in accordance with the ATSA
Code of Ethics and take steps to protect the organization and the individuals
within.
The
former section of Multiple Relationships is now titled Dual Relationships and
has the following section has been added to help navigate social media, electronic
communications, texting, and phone usage. Members shall clarify with clients
what are considered appropriate means of communication to avoid dual
relationships and to protect client confidentiality, which may include interacting
via social media, electronic communication, and/or phone.
An
important addition to this COE is Record Keeping. We encourage you to
familiarize yourself with your professional obligation regarding good records,
keeping them confidential, treatment planning and document storing, accessing,
transferring and disposing of records.
Professional Relationships
It
is not uncommon that many of our clients have been in treatment with another
treatment provider. The committee felt it was imperative to clarify the
importance of making reasonable attempts to contact any current or previous
practionners.
Research and Publications
Note
the addition in this section: Members shall be aware that incarcerated
individuals, probationers and patients in secure forensic settings are
vulnerable populations and that, therefore, additional human subject
protections may apply.
SECTION 2 Rules and Procedures
Perhaps
the most noticeable change in this section is that the ATSA ethics committee
will no longer rely on a Special Advocate and the committee can commence an
investigation by its own motion. Of course it goes without saying that if a
complaint does come to the committee, then committee members will recuse
themselves if they have a conflict of interest with any party that is involved
in the complaint.
Procedurally,
we encourage Members to address their concerns at the lowest level when
possible. The ATSA Ethics Committee also encourages you to seek consultation
from any of its members or a colleague.
New ATSA Members
The following ATSA members were approved for Membership from June to September 2017.
Sharon Acevedo, LMSW
Tucson, AZ, United States |
|
Fred
A. McCormack, MSW
Newburgh, NY, United States |
Davina Aidoo, C.Psychol
Sandys, Bermuda |
|
Erin McDaid, MSW/LLMSW
Port
Huron, MI, United States |
Mark Babula, Psy.D.
TOLEDO, OH, United States |
|
Wade McIntyre, LPC-MH
Sioux
Falls, SD, United States |
Jason Bailey, MA, LMHC, SOTP
Bothell, WA, United States |
|
Dana Michniewicz,
M.A.
Norristown, PA, United States |
David Barnum, PhD
Overland Park, KS, United States |
|
Maureen M. Mihelic,
BA
Liberty, MO, United States |
Airynn Barton, BA
Phoenix, AZ, United States |
|
Emily Minnick,
Ionia, MI,
United States |
Cassandra Bates
Paw Paw, MI, United States |
|
Danience Moreland,
MA
Raytown, MO, United States |
Terri Bauer, LCSW, LSOTP
McKinney, TX, United States |
|
Jodie T. Morgan, M.A.
Mount
Pleasant, SC, United States |
Anne Bethune, LCSW
Kansas City, MO, United States |
|
Scott Morgano,
LMSW
Newburgh, NY, United States |
Linda Black, MA
Portage, IN, United States |
|
Scott Murie
Guelph, Ontario,
Canada |
Timothy Blaney
Buffalo, WY, United States |
|
Raymond Nelson, M.A.,
NCC
Lafayette, IN, United States |
Vanessa Bouchet, LPCC-S
Bethesda, OH, United States |
|
Mallory Obermire, Ph.D.,
L.P.
Saint Paul, MN, United States |
Lindsay Bruckner, MSW, LCSW
Pierre, SD, United States |
|
Ryan Panaro, LICSW
Jamaica
Plain, MA, United States |
Jessica Brueggen,
Black River Falls, WI, United States |
|
Roberta Paquette-Monthie,
LMSW
Coxsackie, NY, United States |
Matt Burgan, M.A.
San Diego, CA, United States |
|
Rachael Pascoe, MSW,
RSW
Toronto, Ontario, Canada |
Claudia Chacon, BA Psychology
Sierra Vista, AZ, United States |
|
James Prickett,
Ph.D.
Woodward, IA, United States |
Jasmin Chrzan, MA
Kalamazoo, MI, United States |
|
Kenneth T. Rohrbach,
MA
Reading, PA, United States |
Meghan Cibelli, L.M.S.W.
Poughkeepsie, NY, United States |
|
Jennifer Rohrer,
Ph.D.
Savannah, GA, United States |
Christin Collier, LMSW
North Charleston, SC, United States |
|
Nicole Roseberg, LPC
Inkom,
ID, United States |
Bruce Cowan, M.A.,
B.S.W.,B.A.,C.G.C.,R.S.W.
Chatham, Ontario, Canada |
|
Vicki Roush, LLP
St. Louis,
MI, United States |
Diewke de Haen,
Ottawa, Ontario, Canada |
|
Loretta Rowley-Sipple,
LPC
Anchorage, AK, United States |
Denise DeRosa,
Hartsdale, NY, United States |
|
Justyna Rzewinski, LMSW
New
York, NY, United States |
Danielle Dill, Psy.D.
marcy, NY, United States |
|
Shannon S. Sanders,
Ph.D.
Cherokee, United States |
Danielle Doyle, LCSW
Holly Springs, NC, United States |
|
Clelia Scaccia,
LMSW
Clayton, MO, United States |
Margaret Evans, MA, Dip Ed Psych
motueka, TAS, New Zealand |
|
Brooke Schluter,
Mauston,
WI, United States |
Michelle Feiszli
Rapid City, SD, United States |
|
Maia Semerzier,
MSW
Manchester, NH, United States |
Gloria D Fondren, Ph.D, LPC, LSOTP
Windcrest, TX, United States |
|
Alina Shaw,
Ph.D.
Steilacoom, WA, United States |
Mandi Fowler, PhD, LICSW, PIP
Tuscaloosa, AL, United States |
|
Paul Shawler, Ph.D.
Oklahoma
City, OK, United States |
Juanita Gamache, M.A., NCC, LPC/MHSP
Nashville,
TN, United States |
|
Tiffany Sheely, MS,
LPC
Lewiston, ID, United States |
Brenna Gatimu, MSW
Casper, WY, United States |
|
Jessica Shouler, MS,
LMFT
Mankato, MN, United States |
Leslie Gohlke, MSW
Albany, NY, United States |
|
Louis Sisto, LCPC, CADC,
LASOP
Rushville, IL, United States |
Amber Gonzalez, M.S.
Grand Rapids, MI, United States |
|
James Slaughter, Jr., M.S.,
M.A.
Locust Grove, GA, United States |
Erin Gould, LPC
Farmington, MO, United States |
|
Ashley Smith, MSW
Rushville,
IL, United States |
Amanda Graham, Psy.D.
Bristol, FL, United States |
|
Jerry Smith, Psy.D., LP,
ASOTP
The Woodlands, TX, United States |
Stephanie Gummerson, Reg Psych
Woodstock, Ontario, Canada |
|
Jerry H. Smith, Jr., Psy.D,
M.A.
Wilmington, NC, United States |
Antoni Hanigan, Psy.D.
, NE, United States |
|
Brianna Snell, LAC
Mesa, AZ,
United States |
Audrey Hanmer, MS
Fridley, MN, United States |
|
David Sorrentino, LPC,
CSOTP
Glen Allen, VA, United States |
Jennifer Harris, LCSW
Grand Junction, CO, United States |
|
Christina Spraker,
LCSW-R
Hyde Park, NY, United States |
Kimone A. Harris,
Meriden, CT, United States |
|
Dominic Strodes, M.A., BSW,
LSW
Springfield, OH, United States |
Leah Hicks,
Lumberton, TX, United States |
|
David J. Sundem, M.S., NCC,
LPC
Sioux Falls, SD, United States |
William Kelly Hill, MC
Boise, ID, United States |
|
Tammy S. Teel, MSEd
, United
States |
Greg Hobson, MA, LMHC
Wabash, IN, United States |
|
Vanessa K Tower, M.S.W.,
LISW-S
Columbus, OH, United States |
Jimmy Hodges, MPA
Fayetteville, GA, United States |
|
Ann Marie Troy,
LCSW-R
Poughkeepsie, NY, United States |
Tammy K. Jackson,
Omaha, NE, United States |
|
Maureen Tweedy,
Ph.D.
Chicago, IL, United States |
Christina Johnson, Registered
Psychotherapist
Lakewood, CO, United States |
|
Mikaela Vidmar-Perrins,
M.Sc.
Dartmouth, Nova Scotia, Canada |
Rebecca Jones,
Phoenix, AZ, United States |
|
Alan von Kleiss, PsyD, ABPP,
LCP, CSOTP
Richmond, VA, United States |
Tamara Kang, Ph.D.
Teaneck, NJ, United States |
|
Helena Walkowiak, MA
Red
Hook, NY, United States |
Amy Karn, Psy.D.
Oshkosh, WI, United States |
|
Candice Waltrip, PsyD
Orem,
UT, United States |
Jaron Kennedy, MAC
Casper, WY, United States |
|
Tracie Webb, LLP
Muskegon,
MI, United States |
Gregory P. Kerry, Ph.D.
Plainfield, Ontario, Canada |
|
Abbigail Wehling,
LAPC
jamestown, ND, United States |
Katherine King, MA
Kalamazoo, MI, United States |
|
Aaron Weiss, Bachelor of
Arts
Caro, MI, United States |
Lee King, LADAC
Las Cruces, NM, United States |
|
Michell Wellman, MA,
LLP
Muskegon Heights, MI, United States |
Shannon King, Masters Professional
Counseling
Mesa, AZ, United States |
|
John Wiginton,
Oxford , AL,
United States |
Andrea Kiss, MS
Syracuse, NY, United States |
|
Harold Williams,
LPA
Raleigh, NC, United States |
James Kissinger, MA Counseling
Psychology
Lansing, MI, United States |
|
Lindsey Wilner,
Psy.D.
Saratoga Springs, NY, United States |
John Koppenhaver, LC{
Wichita, KS, United States |
|
Evan Wouters, MA
Kalamazoo,
MI, United States |
Deborah Koricke, Ph.D.
Fairview Park, OH, United States |
|
William Yeatts, PsyD
Dallas,
TX, United States |
Cheryl Krawietz, LCPC
Lincoln, ME, United States |
|
Sara Zegalia, LPC
Jessup,
PA, United States |
Michael Loguercio, BA
Kew Gardens, NY, United States |
|
Alexandra
Zidenberg
Saskatoon, Saskatchewan, Canada |
|