ATSA ForumNovember 30, 1999
Editor's Note
by Heather Moulden, Forum Editor
For many of us Fall is a time of new starts –
a mix of returning to the comfort of routine and familiar combined with the
hope and excitement of embarking on new endeavours. I hope you all had a
wonderful summer and I invite you to read on and check out the stimulating and
informative articles we have for you in this issue of the Forum.
There has been a movement across the field to
be more thoughtful and deliberate about our language and the terms we use to
refer to those with whom we work. It occurred to me that despite refraining
from describing clients as “sex offenders” in my clinical work, I continued to
use the term in research writing until more recently. Change is hard, but
surprisingly, less hard than one would expect, when its the right thing to
do. Gwenda Willis and Elizabeth Letourneau
share their insights, experiences and suggestions for ATSA members with respect
to new language and the meaning attached.
Our other feature article shares critical
reflection on manualized treatment, and the political/fiscal factors that
influence decisions regarding treatment implementation in two states. The
authors provide descriptions of how each program/state attempted to integrate
the manuals into their practice, the outcomes of the experience, and the pros
and con of manualized treatment.
Our committee updates come from two
complimentary pieces authored by the chairs of the Juvenile and Adult Clinical
Practice Committees to introduce a new regular feature in the Forum. The Clinical Corner will be a column devoted
to clinical practice issues and ideas, with alternating contributions from each
clinical committee. Both committees have long identified the importance of a dedicated
newsletter space addressing treatment, assessment and management exclusively.
Read on to learn more about it, and please look for the Clinical Corner column in your upcoming issues of the Forum.
As the conference approaches, many ATSA
members are anticipating the many benefits of attending the meeting and related
events. But for our students, especially those new to the field, these rewards may be a little abstract or
unknown altogether. Thankfully, Carissa Toop from the Student Committee can
provide some insight as she shares her experiences becoming involved with ATSA.
This is a great article to share with non-member students, and student members
alike. It provides an orientation to the many wonderful student focused
offerings at the conference and also the value of becoming involved with the
organization.
David Prescott and Becky Palmer have included
not one, not two, but three book reviews for your reading pleasure, with
excellent suggestions for additions to your bookshelf. And finally, Danielle
Harris kindly answered our FAQ on the use of the term “sexual harm” in this
issue.
Please
send me your comments, suggestion, ideas and articles. Enjoy the conference and
Vancouver!
Heather M. Moulden
ATSA Forum Editor
President's Message
by Franca Cortoni, ATSA President 2018-2019
Summer
has wrapped up which means our yearly conference is just around the corner. Our
conference chairs, Drs. Robin Wilson and Carmen Zabarauckas, have done a
fantastic job at developing an enriching program that will appeal to clinicians
and researchers alike.
You
will recall that elections took place earlier this summer for President, Public
Policy Representative, and Research Representative to the ATSA Board of
Directors. A call for interest for the Treasurer position, which is a Board
appointed position, was also made at that time. A reminder that the President
is elected for a 4-year term: one year as President-Elect, two years as
President, and one year as Past President, while the regular Board members’
positions are 3-year terms, renewable once. I am pleased to announce your newly
elected members: Our current board member and Treasurer Shan Jumper has been
acclaimed as the new President-Elect; Katie Gotch, who had been temporarily
filling the position of representative of Public Policy, has been voted into
the position; and Jeff Sandler was voted to become the new Research Representative
on the Board. Finally, the newly Board appointed Treasurer is Ainslie Heasman. Their
terms will start officially in January 2019, but we are already putting them to
work by inviting the new members to attend our Board meeting in Vancouver. You
will also have the opportunity to meet these new Board members during the ATSA
members’ lunch during the conference in October.
On
the international front, a special issue on international approaches to the
treatment and management of sexual offenders was recently published in the
IATSO journal (IATSO is our sister organization based mostly in Europe). Coordinated
by our international representative on the Board, Kieran McCartan, the special
edition has 12 papers drawn from the international round table that took place
at the 2017 ATSA conference. These papers detail the perspective from
Australia, Belgium, Canada, Germany, Israel, Italy, Netherlands, New Zealand,
Singapore, Sweden, UK, and USA, Canada, Australia, New Zealand, Singapore,
Italy, Germany, Netherlands, Israel, Belgium) from representatives of ANZATSA, ATSA,
ATSA-NL, CoNTRAS-TI, IATSO, and NOTA. Each paper
reviews their respective countries’ approaches to the assessment, treatment,
and management of sexual offenders. I would strongly encourage you to review
these papers as to gain a better understanding of, as well as learn from, the
various perspectives offered in this special issue. Add link… Kieran is checking if it is available
from Martin at IATSO.
Still
on the international front, I am happy to report that in July, a formal
affiliation agreement was signed between ATSA and the Italian organization CoNTRAS-TI
(National Coordination for the Treatment and Research of Sexual Aggression -
The Italian Contribution ([English translation of Coordinamento Nazionale per il Trattamento dell’Aggressione
Sessuale-Testimonianze Italiane]). This agreement provides direct linkages
between our two associations to facilitate the sharing of information on
policies and best practices when working with individuals who have sexually
offended. A representative from CoNTRAS-TI has been invited, as is current
practice with all of ATSA’s sister organizations, to attend the meeting of the
ATSA Board of Directors that takes place the day preceding the ATSA
conference.
Work
on the International Treatment Study is progressing. The next step is to
establish the parameters of the treatment program that will be tested. To that
end, the international experts panel, comprised of treatment providers and
researchers, is reviewing the literature to determine the core elements that
constitute current best practices in the treatment of individuals who have
engaged in sexual offending behavior. This is a complex endeavor to ensure our
treatment program reflects best international practices. We are very lucky that
so many individuals have agreed to provide their expertise to this important
work. We will share the results as soon as they become available.
Until
then, I hope that you will be able to join us at our yearly conference to
discover the latest research findings, learn about new clinical approaches, and
renew or establish new relationships with colleagues and friends in Vancouver!
Michael Miner
Is there such thing as “sexual harm” or is it always Abuse or Trauma?
By Danielle Arlanda Harris, Toni Cash, Kerri Wyeth & Kieran McCartan
Danielle Arlanda Harris,
PhD, Griffith University
Toni Cash, and Kerri Wyeth,
Queensland Department of Child Safety, Youth and Women
Kieran McCartan, PhD,
University of the West of England-Bristol
We applaud Sexual Abuse’s recent guest editorial in which Willis and
Letourneau (2018) promote the use of person first language. In light of #metoo
and the “Weinstein event,” people are now engaging in nuanced public
discussions about the difference between sexual abuse, sexual assault, sexual
exploitation, and sexual harassment. These are not the same thing, they do not
have the same consequences, or carry the same penalties, and should not be
viewed similarly. Here, we consider the specific phrase of “sexual harm.” As we
continue to negotiate our use of language, we must also navigate both
legislation and legal jargon as it is used across numerous jurisdictions.
“Sexual harm” is frequently used as a
catchall phrase intended to include various types of violence, abuse, assault,
and harm that results from sexual abuse or violence of a sexual nature. The
idea of harm—as opposed to other language (i.e., abuse, trauma, etc.)—comes
from the field of Zemiology, based on the idea that “harm” is more proactive
and adaptive than other terms. However, the word “harm” is divisive, especially
from the perspectives of criminal justice and victim advocacy groups who argue
that “harm” lessens the impact and consequences of exactly what a person
experiences as a result of sexual abuse.
According to the Queensland Department of
Child Safety, Youth, and Women, the harm that a person experiences as a result
of sexual abuse is either:
(1) Emotional/psychological harm,
(2) Physical harm or,
(3) Both emotional/psychological and
physical harm.
For example, if a 16 year old girl discloses
that her stepfather broke her arm three years ago, she would be referred to a
doctor to ensure that the arm was set properly and the break has healed
(treating the physical harm) and referred to a counsellor to attend to the
emotional stress and trauma caused by the incident (treating the psychological
harm). Likewise, if a 16 year old girl discloses that she was vaginally
penetrated three years ago by her stepfather, she should similarly be referred
to a doctor for an internal exam to ensure that there is no lasting damage,
that her vagina has healed (treating the physical harm) and be referred to a
counsellor to attend to the emotional stress and trauma caused by the same
incident (treating the psychological harm).
Basically, if we understand the harm to
be physical then we can target our intervention to the physical harm and if we
understand the harm to be emotional then we can target our intervention to the
emotional harm.
To be clear, “sexual violence” describes
the behaviour that someone is responsible for committing. The “harm” is the
resulting impact on the person who has experienced the sexual violence. Quite
simply, when someone experiences violence, their resulting physical harm can be
treated by a medical doctor and their resulting emotional harm can be treated
by a counsellor. The challenge with the use of the phrase “sexual harm” is that
it can lead to confusion over how best to help the actual harm that the person has experienced. By observing the
presence of the resulting physical and
emotional harm that results from the commission of sexual violence we can offer
a clear direction for interventions that best cater to the needs of the
individual and the actual harm they have experienced.
Hillyard,
P. (with C. Pantazis, S. Tombs and D. Gordon) (2004) Beyond
Criminology: Taking Harm Seriously, London: Pluto Press.
Queensland
Department of Child Safety, Youth and Women https://www.csyw.qld.gov.au/child-family
Willis, G. M.
(2018). Why call someone by what we don't want them to be? The ethics of
labeling in forensic/correctional psychology. Psychology,
Crime & Law, 24 (7), 727-743. 10.1080/1068316X.2017.1421640
Willis, G. M. &
Letourneau, E. (2018). Promoting accurate and respectful language to describe
individuals and groups. Sexual Abuse, 30(5),
480-483.
Moving beyond the “sex offender” dialogue: How ATSA members can promote person-first language
Gwenda M. Willis School of Psychology, University of Auckland & Elizabeth J. Letourneau Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
Gwenda M. Willis
|
Elizabeth J. Letourneau
|
Author Note
Gwenda M. Willis,
School of Psychology, University of Auckland.
Correspondence concerning this article should be addressed to Gwenda M.
Willis, School of Psychology, The University of Auckland, Private Bag 92019,
Auckland 1142, New Zealand.
g.willis@auckland.ac.nz
ORCID ID: orcid.org/0000-0001-9827-3397
There is growing recognition that individuals
convicted of sex crimes can and do desist from sexual offending (Caldwell, 2016;
Hanson, Harris, Helmus, & Thornton, 2014; Hanson, Harris, Letourneau,
Helmus, & Thornton, 2018), that people with sexual interest in children often desire help to
avoid acting on their attractions (Beier et al., 2009) and that sexual abuse perpetration is preventable (Letourneau, Eaton,
Bass, Berlin, & Moore, 2014). It would seem
that to some extent, professionals and (to a lesser degree) the public are
moving away from viewing everyone who has engaged in harmful or illegal sexual
behavior and/or who has sexual interest in children as presenting a high risk
of offending. That is, we are slowly
shifting away from viewing people who have or might sexually offend as “monsters”. Yet the labels we use in our professional work
may align more closely with the “monster” label than with a humanistic and
prevention-oriented approach. Many
professionals, organizations and scholarly publications continue to label and
define the people at the center of their work based on their behavior or
attractions (e.g., “sex offender,” “abuser” “pedophile”[1]). ATSA, like its sister organizations NOTA and
IATSO, is no exception, using the “Abuser” label in its name. Similarly, labels appear in the titles and
content of several books currently in circulation for treatment providers (e.g., Carich &
Musack, 2015; Prescott, 2009; Sawyer & Jennings, 2016; Yates, Prescott,
& Ward, 2010), many treatment program names (e.g., “Sex Offender Treatment Program”
or “SOTP”) and in clinicians’ and evaluators’ everyday communication. The frequent use of such labels by subject
matter experts risks ostracizing the very people we seek to help while reinforcing
erroneous public beliefs that these people are beyond help.
In August 2018, ATSA’s journal Sexual Abuse published a guideline encouraging the use of person-first
language to describe individuals and groups in manuscript submissions (Willis &
Letourneau, 2018). In this
article, we encourage all of our ATSA friends and colleagues to consider
promoting person-first language more broadly – from the names of treatment
programs and agencies, to report writing and during informal conversations with
family and friends. First, we summarize some
of the problems with the offense and attraction-based labels commonly assigned
to our clients.
Problems with the “sex offender” and other commonly
used labels
Labels
promote misperceptions. The “sex offender” label suggests that is who someone is. Inherent in the label is the assumption
that “once an offender, always an offender.” Indeed, Harris and Socia (2016) found that survey respondents who read about “sex
offenders” rated them as less responsive to treatment and were more supportive
of contemporary sex crime policies than survey respondents who read about
“people who have committed crimes of a sexual nature”. Findings were even more robust for the
“juvenile sex offender” label. Yet it is
well established that sexual recidivism
base rates are low, and moreover, that rates decline with time spent offense-free
in the community (Hanson et al., 2014; Hanson et al., 2018). Offense-based labels further suggest that individuals with a history of
sexual offending represent a homogenous group whose members all present a
comparable likelihood of reoffending.
However, individuals who commit crimes of a sexual nature are diverse
across most characteristics (apart from gender), including with respect to
their risk profiles. Some “sex offenders” present an above average
risk of sexual recidivism, perhaps due to a combination of numerous priors,
atypical sexual interest, and low connection to social institutions, whereas
others assigned the same “sex offender” label present a risk of sexual
recidivism indistinguishable from people with only nonsexual offense
convictions (see Hanson et al., 2018).
Offense-based labels like “sex offender,” “child
molester” and “rapist” convey little about the etiology of offending, treatment
needs, or future risk of specific individuals.
As such, these labels lack validity.
By contrast, other labels commonly assigned to persons who have offended
or are at risk of offending are based on valid constructs (e.g., “psychopath”,
“pedophile”). Even so, these labels carry
negative connotations and risk stigmatizing the person behind the label (Imhoff, 2015).
Labels risk
stigmatizing individuals and groups. It is well documented that individuals labeled a “sex
offender” struggle integrating into society; for example, they struggle
securing stable housing and employment (for a review of
literature on attitudes towards persons who have sexually abused, see Harper,
Hogue, & Bartels, 2017). Many labels
commonly used by professionals might be perceived as stigmatizing and
pejorative, and not self-selected by the individuals and groups to whom they
are assigned. Respect for the dignity
of all persons is a core ethical principle in codes of ethics across the
helping professions (e.g., American
Psychological Association, 2010a; Code of Ethics Review Group, 2012; The
Australian Psychological Society, 2007; The British Psychological Society,
2009), and addressed explicitly in the American Psychological Association
(APA) Publication Manual (APA; 2010b). Specifically,
the APA manual states that “A label should not be used in any form that is
perceived as pejorative; if such a perception is possible you need to find more
neutral terms” (p. 72).
Of course, individuals vary in their perceptions of
labels to the extent that some self-select labels we might generally wish to
avoid using. Such a contradiction is
evident amongst the population of individuals with sexual interest in young
children. Some individuals choose to use
labels that acknowledge their sexual interest in children – for example, they
might refer to themselves as “minor-attracted persons” or “virtuous pedophiles”
(see also Malone, 2014). The APA Publication
Manual encourages authors to “respect people’s preferences; call people what
they prefer to be called” (p. 72). When
working with an individual or writing up a specific case, it is straightforward
to follow this recommendation to respect an individual’s labeling preferences. However, how might professionals respect
different labeling preferences when referring to groups of people presenting
with similar psychological phenomena (e.g., pedophilia)? Person-first language offers a neutral solution.
Person-first language
As its name
suggests, person-first language separates a person from a behavior, condition
or disorder (e.g., “persons with sexual offense histories,” “individual with
sexual interest in children”, “child/adolescent with sexual behavior problems”). Person-first language encourages us to
describe individuals and groups with greater precision, increases the
likelihood that others will perceive these individuals as amenable to
intervention, and reduces the likelihood of demeaning those we describe by assigning
a label that they might not self-select (see Willis, in press).
In the broader educational and psychology literature,
person-first language is commonplace.
For example, we no longer refer to individuals with intellectual
disabilities as “mental retards” or even “intellectually disabled,” and persons
with schizophrenia could not be labeled “schizophrenics” in modern journal articles. We believe that with time and effort, similar
change is achievable in our field. It
might be argued that individuals who have engaged in harmful or illegal sexual
behavior do not deserve the same considerations as individuals with intellectual
or mental health problems. Many would
say that people who cause harm, particularly sexual harm, deserve the labels
they have been assigned. We
disagree. Human rights, including the
right to dignity, apply to everyone, including people who have caused
harm. While it is important to
stigmatize harmful behavior, it is
counter-productive to stigmatize people.
How might ATSA members promote person-first
language? Sexual Abuse has set a precedent and we hope that the broader ATSA membership
will follow. We encourage ATSA members
to look closely at the names of the agencies they work for, the treatment
programs they run, and the academic courses and professional training programs they
offer. Are the names and titles of these
efforts consistent with a person-first approach? Or do they inadvertently reify the image of certain
groups as homogenous and high risk?
Likewise, we encourage ATSA members to examine how they describe their
clients or research subjects when talking with the media, during court
appearances, and within clinical and scholarly writings. Beyond work settings, we encourage ATSA
members to reflect on how they describe their work and client groups to
friends, family and others. As
professionals, we model for the public how to talk about and, therefore, how to
think about the people with whom we work.
We (Gwen and Elizabeth) have each used the very labels
that we now protest; we recognize that changing from offense-first to
person-first language is a process. We can attest that it gets much easier with
practice. We are also aware that many ATSA
members initiated person-first usage long before we did and we are grateful for
these efforts. ATSA members have
grappled several times with our organization’s title and will no doubt do so
again. Regardless of whether we change
the ATSA name, we can all change how we describe those with whom we work. Anything we do that makes it easier for
others to view the people with whom we work as people will make our work easier and more effective.
References
American Psychological Association.
(2010a). Ethical Principles of
Psychologists and Code of Conduct (With the 2010 Amendments). Retrieved
from http://www.apa.org/ethics/code/principles.pdf
American
Psychological Association. (2010b). Publication
Manual of the American Psychological Association (6th ed.). Washington,
D.C.: American Psychological Association.
Beier, K. M.,
Ahlers, C. J., Goecker, D., Neutze, J., Mundt, I. A., Hupp, E., & Schaefer,
G. A. (2009). Can pedophiles be reached for primary prevention of child sexual
abuse? First results of the Berlin Prevention Project Dunkelfeld (PPD). The Journal of Forensic Psychiatry &
Psychology, 20, 851-867. 10.1080/14789940903174188
Caldwell, M. F.
(2016). Quantifying the decline in juvenile sexual recidivism rates. Psychology, Public Policy, and Law, 22,
414-426. 10.1037/law0000094
Carich, M. E.,
& Musack, S. (Eds.). (2015). The
Safer Society Handbook of Sexual Abuser Assessment and Treatment. Brandon,
VT: Safer Society Press.
Code of Ethics
Review Group. (2012). Code of Ethics for Psychologists Working in Aotearoa New
Zealand. Retrieved July 6, 2016, from http://www.psychologistsboard.org.nz/cms_show_download.php?id=237
Hanson, R. K.,
Harris, A. J. R., Helmus, L., & Thornton, D. (2014). High-Risk Sex
Offenders May Not Be High Risk Forever. Journal
of Interpersonal Violence, 29, 2792-2813. doi: 10.1177/0886260514526062
Hanson, R. K.,
Harris, A. J. R., Letourneau, E., Helmus, L. M., & Thornton, D. (2018).
Reductions in risk based on time offense-free in the community: Once a sexual
offender, not always a sexual offender. Psychology,
Public Policy, and Law, 24, 48-63. doi: 10.1037/law0000135
Harper, C. A.,
Hogue, T. E., & Bartels, R. M. (2017). Attitudes towards sexual offenders:
What do we know, and why are they important? Aggression and Violent Behavior doi: 10.1016/j.avb.2017.01.011
Harris, A. J.,
& Socia, K. M. (2016). What’s in a name? Evaluating the effects of the “sex
offender” label on public opinions and beliefs. Sexual Abuse: A Journal of Research and Treatment, 28, 660-678.
doi: 10.1177/1079063214564391
Imhoff, R.
(2015). Punitive attitudes against pedophiles or persons with sexual interest
in children: Does the label matter? Archives
of Sexual Behavior, 44, 35-44. doi: 10.1007/s10508-014-0439-3
Letourneau, E.
J., Eaton, W. W., Bass, J., Berlin, F. S., & Moore, S. G. (2014). The Need
for a Comprehensive Public Health Approach to Preventing Child Sexual Abuse. Public Health Reports, 129, 222-228.
Malone, L.
(2014). You're 16. You're a Pedophile. You don't want to hurt anyone. What do
you do now? Retrieved from https://medium.com/matter/youre-16-youre-a-pedophile-you-dont-want-to-hurt-anyone-what-do-you-do-now-e11ce4b88bdb#.uj2ff35j6
Prescott, D. S.
(2009). Building motivation for change in
sexual offenders. Brandon, VT: Safer Society Press.
Sawyer, S. P.,
& Jennings, J. L. (2016). Group
Therapy with Sexual Abusers: Engaging the Full Potential of the Group
Experience. Brandon, VT: Safer Society Press.
The Australian
Psychological Society. (2007). Code of ethics. Melbourne, Australia: The
Australian Psychological Society.
The British
Psychological Society. (2009). Code of
Ethics and Conduct. Retrieved from http://www.bps.org.uk/system/files/Public%20files/aa%20Standard%20Docs/inf94_code_web_ethics_conduct.pdf
Willis, G. M. (in
press). Why call someone by what we don’t want them to be? The ethics of
labelling in forensic/correctional psychology. Psychology, Crime & Law doi: 10.1080/1068316X.2017.1421640
Willis, G. M.,
& Letourneau, E. J. (2018). Promoting accurate and respectful language to
describe individuals and groups. Sexual
Abuse, 30(5), 480-483. 10.1177/1079063218783799
Yates,
P. M., Prescott, D. S., & Ward, T. (2010). Applying the Good Lives and Self Regulation Models to sex offender
treatment: a practical guide for clinicians. Brandon, VT: Safer Society
Press.
[1] Labels will not
be used by the authors unless referring to current usage, which will be
indicated by quotation marks or italics.
Pros and Cons of Manualized Approaches to Sexual Abuse Specific Treatment: Experiences of Programs in Kansas & Oregon
Katherine Gotch, Tiffany Looney, Seth Wescott & Marc Schlosberg
Katherine Gotch
|
Tiffany Looney
|
Seth Wescott
|
Marc Schlosberg
|
There has been a recent movement,
often driven by policy makers and/or correctional agencies, in varying
jurisdictions within the United States for the manualization of sexual abuse
specific treatment programming. The reasons for this movement have been
identified as fiscal, to strengthen evidence-based practices, and/or to address
resource limitations such as a lack of qualified clinical staff in rural areas.
However, what are the benefits and deficits for implementing this type of scripted
manualized approach?
The
Kansas Experience:
The Kansas Department of
Corrections (KDOC) contracts with a private, for-profit agency (Clinical
Associates) to provide sexual offense specific evaluation and treatment
services for incarcerated offenders and parolees throughout Kansas. Clinical
Associates is the sole-source provider for these services and treatment is
conducted at four correctional facilities and seventeen outpatient locations
across the state. In 2014, following trends in correctional practices, KDOC
asked Clinical Associates to implement a scripted manualized curriculum. The
rationale for switching from an individualized, risk/need/responsivity approach
to a scripted manualized approach was based on Kansas data which suggested that,
although recidivism for sexual offenses was quite low (less than 3%), parole
revocations for technical violations was much higher (close to 40%) and that a
structured, skills-building approach would better assist in the reduction of
criminogenic needs and lead to greater success on parole. The KDOC identified a
specific curriculum to be utilized and training on the curriculum occurred in
early 2015, with program implementation occurring in the spring of 2015. The
first cohort finished treatment in summer 2015. Implementation proceeded slowly
due to logistical issues within facilities, and only 8% of all those who
completed in Fiscal Year 2016 (FY16) had received the manualized curriculum. By
the conclusion of FY17, that number had climbed to 68%. In FY18, 73% of all
those who completed the program had received the curriculum.
Clinical Associates’ theoretical
model was previously grounded on the principles of risk, need, responsivity;
utilized Good Lives Model approaches; promoted healthy sexuality; focused on
increasing personal accountability and decreasing dynamic/criminogenic areas of
need; and used the polygraph to validate self-report. From 2011 to 2015,
Clinical Associates provided facility-based programs in three prisons (and
expanded to include a fourth facility in 2018). These programs lasted from four
to six months (based on level of risk) and involved group and individual
sessions, as well as non-traditional interventions/programming for responsivity
issues for individuals who possessed high psychopathy, low intellectual
functioning, and/or severe and persistent mental illness. Seventeen outpatient
offices provided community-based programming which lasted from six to
twenty-four months (based on level of risk) and involved group and individual
sessions, as well as non-traditional interventions/programming for responsivity
issues. All treatment programs were individualized and focused on stable risk
factors, criminogenic needs, intimacy deficits, sexual deviancy, and
pro-offending attitudes.
Since 2015, the scripted manualized
curriculum has been the required programming that Clinical Associates provides
within all facility-based programs and has been piloted in the community. As
noted previously, a main driver for implementation of the manualized curriculum
was to address parole revocations for technical violations as it was the belief
that a structured, skills-building approach would better assist in the
reduction of criminogenic needs and lead to greater success on parole. However,
the initial data compiled by Clinical Associates has demonstrated that this
goal has not yet been achieved. Additionally, as there is no longer the flexibility
to individualize programming based upon the principles of risk, need,
responsivity, the scripted manualized curriculum has a higher overall cost (see
below).
Kansas Outcome Data |
FY16 |
FY17 |
FY18 |
Completions |
281 |
191 |
219 |
Cost per Completion |
$3197.15 |
$4703.66 |
$4102.28 |
The primary responsivity issues
addressed in the required curriculum are poor motivation and resistance. There
are no guidelines or suggestions for altering the curriculum for individuals
who are lower functioning, who have severe and persistent mental illness, or
who present with high psychopathy.
Clinical Associates utilizes the
polygraph as a component of treatment. In the facility-based program,
participants complete and process a sexual history in preparation for the
sexual history disclosure polygraph. In order to prepare participants for the
sexual history assignment, treatment time must be devoted to discussing
specific sexual behaviors, a topic not addressed in the curriculum.
Although the required curriculum is
reported to be rooted in the risk, need, responsivity principles, the scripted curriculum
itself allows for minimal variability among the different risk levels. While
the curriculum is designed for use with individuals of above average and well
above average risk (formerly moderate high and high risk categories), there is
not a published low dosage version for those who are average or below average
risk. Clinical Associates assesses all participants prior to program entry, and
their Static-99R and STABLE-2007 scores are noted. Kansas’ data suggest that
approximately 28% of offenders score above average or well above average risk on
the combined Static-99R/STABLE-2007, leaving the majority of offenders (approximately
70%) outside the recommended criteria for participation. Rather than provide
treatment to only 28% of sexual offenders, Kansas chose to include those who
were average and below average risk, while excluding only those assessed as
very low risk. This has resulted in a treatment program challenged to maintain
best practices due to the primary curriculum it is currently required to use.
The
Oregon Experience:
In Oregon, there are no
institutional sexual abuse specific treatment programs and treatment services
are typically provided after an individual has completed all in custody
sanctions and is placed on community supervision (probation, parole or post
prison). Community corrections in Oregon is also primarily county versus state
managed, meaning that each county has the choice of how they may implement or
pilot new programs or services within their jurisdiction. A level of statewide
consistency is maintained through the Oregon Association of Community
Corrections Directors (OACCD), as
well as the statewide Sex Offender Supervision Network (SOSN), a
multi-disciplinary professional network which guides best practice standards
for sexual offense specific supervision and management.
McKenzie Counseling is a
community-based agency providing sexual offense-specific treatment in Lane
County, the second-largest metro area in Oregon. McKenzie Counseling was required to pilot a scripted
manualized curriculum as a condition of the contract with the Lane County
Parole and Probation Department. Several
other sexual offense specific treatment programs around the state also participated
in the pilot project, with varying degrees of fidelity as some programs had the
ability to implement the curriculum with considerable flexibility, integrating
aspects of the manualized approaches into their existing programming. McKenzie Counseling was required to conduct a
pilot with strict adherence to the scripted manual, delivering all modules
completely and in sequence, without use of other materials or
interventions.
For logistical reasons McKenzie
Counseling conducted the pilot as an open group, with 14 participants at the
outset. All participants scored moderate
or higher on a validated risk assessment instrument (Static-99R or LS/CMI). Attrition was 50% for the initial group due
to issues with motivation, supervision violations or absconding supervision, substance
use, and lack of attendance or homework completion. Due to these attrition issues, new participants
were added at open modules, keeping the group size at approximately 12 for the
duration of the pilot. Two state certified
sexual offense specific master level clinicians facilitated all service
delivery of the manualized curriculum.
Although marketed as a sexual
offense-specific intervention and program, it was noticeable that the scripted manualized
curriculum did not directly address sexual self-regulation criminogenic needs or
sexuality more broadly. For this reason,
clients selected for the pilot were those who presented with predominantly
general criminogenic risk/need profiles versus those presenting primarily with
sexual self-regulation needs. As such, it was recognized from the onset that
these individuals were not a representative sample of adult males convicted of
sexual crimes and, therefore, the generalizability of the outcome data would be
limited. However, McKenzie Counseling felt
an ethical obligation to place clients whose primary areas of need related to
sexual self-regulation into treatment groups where those issues would be
addressed.
The manualized curriculum was
presented in its entirety, as scripted, with a few exceptions. The manual directs facilitators to limit
check-in time at each group to no more than 10 minutes. It was necessary to do away with this
limitation to adequately address the concerns of our high-needs, high-responsivity
clients. Additionally, the clinicians
were not comfortable treating clients without the opportunity to conduct
ongoing screening for acute risk factors or have a general idea of what was
pertinent in their clients’ lives in the moment. From a more philosophical standpoint, the
clinicians additionally disagreed with abdicating the transactional nature of a
therapeutic interaction in favor of a unidirectional, solely didactic
approach. Ultimately, it was decided to
extend the group from 90 to 120 minutes to provide adequate time to address
clients’ current concerns and still meet the structured time for delivery of
the manualized curriculum for each session. Client feedback revealed support
for this choice as captured by this client’s statement: “If we didn’t get to
check in, it would feel like all you cared about were the lessons, and not
about us.”
Client feedback was solicited at
regular intervals throughout the pilot project with the clients reporting that
they found the skills useful in their daily lives and also appreciated the
goal-oriented nature of the sessions. The
group sessions were interactive and generally lively, with group members appreciating
that everyone was working on the same thing, at the same time. However, many of the participants also found the
format repetitive and reported greater benefit when they received more explicit
instruction for the skills taught. From a facilitator perspective, observed engagement
was generally good, even for those clients about whom there were initial
concerns regarding lack of motivation. The
manualized materials appeared to be a good fit for clients with a more concrete
cognitive style, as well as those who are less sophisticated or
psychologically-minded.
However, the manual often read
like a rough draft, with typographical errors, unclear directions, and sections
appearing to have been cut and pasted directly from the substance abuse
treatment curriculum developed by the same authors. Rigid lesson structure made it exceedingly
difficult to address client responsivity factors, while reading from a script felt
artificial and demeaning for licensed mental health professionals. There were additional instances where it was
necessary to spend considerable time with certain clients individually, to
address current issues that there was not time for in group.
Going forward, McKenzie
Counseling intends to continue facilitating a group that works predominantly
from the manual (with modifications) for clients whose dominant areas of need
are related more to general criminogenic factors versus sexual self-regulation. McKenzie Counseling additionally intends to
integrate aspects of the curriculum which was found most useful into our
broader program as there are features of the materials which, when delivered with
flexibility and in accordance with the principles of Risk-Needs-Responsivity, would
serve to promote the mission of enhancing community safety by delivering
evidence-based programming to reduce recidivism risk and promote the welfare
and quality of life for the clients served.
Best
Practices in Sexual Abuse Specific Treatment:
As outlined within the ATSA Adult
Practice Guidelines[i],
sexual abuse specific treatment is designed to assist clients to effectively
manage thoughts, fantasies, feelings, attitudes, and behaviors associated with
their potential to sexually abuse. In addition to reducing risk for sexual
and/or non-sexual recidivism, treatment is designed to assist clients to
develop a prosocial lifestyle that is inconsistent with offending. It is also
recognized that effective sexual offense specific treatment incorporates the
risk, need, responsivity (RNR) principles, and that sexual offense specific treatment services are matched to the assessed
recidivism risk and treatment needs of a given client – individualization
of treatment programming based upon validated risk/need assessment, as well as
responsivity factors, has become the gold standard within sexual offense
specific treatment.
Additionally, research has
demonstrated that programs which adhered to the RNR principles showed the
largest reductions in sexual and general recidivism[ii].
This indicates that RNR principles should be a major consideration in the
design and implementation of treatment programs for individuals convicted of
sexual crimes. Specifically, clinicians need to be allowed the freedom to individualize
treatment by tailoring the dosage of services to the level of risk for a given
client (risk principle); address dynamic risk/need factors as the primary
framework for treatment (need principle); and adapt service delivery to meet
the individualized treatment needs of clients in order to maximize their
ability to learn (responsivity principle).
Pros
& Cons of Scripted Manualized Programming
Based upon the experiences of
Kansas and Oregon, the following conclusions were made regarding the pros and
cons of the scripted manualized curriculum:
Pros:
- Structured
and standardized approach
- Modules
are content-specific and cumulative
- Skills
taught are helpful for daily life
- Clients
work on the same things at the same time
- Skills
facilitate healthy communication
- Connect
the dots: Thoughts/Feelings/Behavior
- Deals
with lack of motivation
- Good use
of visual aids
- Teach
skills that address criminogenic needs to reduce revocations
Cons:
- Where’s
the sex?
- One size
fits all - again?
- Time
constraints
- When do
we talk about risk?
- Instruction
against modifications
- Extends
treatment time
- No
outcome data
- Does not
adequately address responsivity
- Some
clients do not need these social skills
- Does not
incorporate or address trauma-informed practices
- Does not
adequately address risk/need factors that have been linked to sexual recidivism
Final
Thoughts:
While there is potential utility
for the scripted manualized curriculum implemented in Kansas and Oregon, it
does not adhere to the principles of risk, need, responsivity or reflect best
practice guidelines for sexual abuse specific treatment; therefore, the
curriculum should not be identified or marketed as such. Based upon the
experiences of Kansas and Oregon, it is recommended that if a scripted manualized
curriculum is to be used, it should be incorporated as part of a larger sexual
abuse specific treatment program, specifically the cognitive component and/or
applicable exercises and handouts rather than as a stand-alone intervention or
approach. The evolution of sexual abuse specific treatment has taught us that individuals
convicted of sexual crimes present with differences in risk, treatment needs,
motivation, and protective factors. If we accept the differentiation among
those we treat, we must also make room for differentiated and individualized treatment.
[i]
Association for the Treatment of Sexual Abusers. (2014). Practice guidelines
for the assessment, treatment, and management
of adult male sexual abusers. Beaverton, OR: Author.
[ii] 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(9), 865-891.
The Clinical Practice Corner: Juvenile Practice
Phil Rich
The juvenile practice and adult practice committees will
begin a new “clinical practice corner” feature in each issue of the Forum, with
contents that will vary from issue to issue, ranging from updates on each
committee and its activities, highlights of relevant ATSA initiatives that have
implications for or influence clinical practice, and other content relevant to
contemporary clinical practice, and also help ensure good communication between
the practice committees and ATSA membership. It is likely that the clinical
practice corner will alternate between the adult and juvenile practice
committees each issue, with the exception of this issue of the Forum in which both
practice committees describe a little of what we’re doing as standing (i.e.,
permanent) ATSA committees, and what we see ahead. For the juvenile practice
committee, this first clinical corner also serves as a bit of an introduction
as the juvenile committee is relatively new and just beginning to take shape
and develop the foundation for what we hope
will be an effective and valuable committee moving forward, in both
representing the ATSA Executive Board and ATSA membership who work with
children and adolescents.
A Brief Introduction
to the Juvenile Practice Committee
The Juvenile Practice Committee (JPC) was formed in early
2017, and to some degree was built on the foundation of the task-focused and
time-limited committee that was formed to develop the first Adolescent Practice Guidelines, which
were released by ATSA in 2017. As that committee disbanded, having completed
its task, the juvenile practice committee was formed, standing on the shoulders
of the adolescent guidelines committee. The juvenile practice committee is
chaired by Phil Rich, the Juvenile Practice Representative on the ATSA Board,
and upon inception and today is a relatively large committee, with 15 members,
listed here in first name alphabetical order, including two international
members (outside of North America, that is): Anette Birgersson (Sweden), Chris
Lobanov-Rostovsky, David Prescott, Janet DiGiorgio-Miller, Jim Worling, Kevin
Creeden, Kevin Powell, Lori Robinson, Michael Caldwell, Michelle Gourley, Phil
Rich, Russ Pratt (Australia), Tanya Snyder, Tom Leversee, and Tyffani Dent.
Much of the initial work of the committee was to decide what
to do as a committee and how to proceed, including the most effective and efficient
way to work as committee. It soon became clear that the work of this large
committee would be most effectively conducted and managed through four
subcommittees: adolescent guidelines,best practices material and resources,external partnerships, and in-reach and membership liaison. These allow
more focused work and are each smaller in size than the full committee, and
also allow for additional subcommittee members who are not themselves members
of the JPC. There is certainly crossover between and interaction among
subcommittees, and several JPC members are on more than one subcommittee.
The Four Subcommittees
Each of the subcommittees is focused on fulfilling tasks
identified in the ATSA strategic plan, as well as developing additional tasks
that we hope will enhance practice. The adolescent
guidelines subcommittee focuses on ensuring that the adolescent practice
guidelines remain dynamic and incorporate new and relevant research and best practices
material into the next revision of the guidelines, as well as working toward
disseminating the practice guidelines. As an early task, the subcommittee has
developed a set of key readings that is intended to supplement the current
adolescent practice guidelines, and this will be made available through the
ATSA website in the near future. The subcommittee is also working to develop a
template of sorts for those wishing to provide training in the use of the
adolescent practice guidelines.
The best practices subcommittee
is developing fact and information sheets to reflect and enhance clinical best
practices, and is in the process of developing several of these at the moment.
Once completed, these will be further reviewed by the full JPC, and then the
ATSA Board before being placed onto the ATSA website. We see this process as
ongoing, with a goal of building an inventory of contemporary practice fact and
informational sheets aimed primarily at professionals, but also useful to the
general public. The external partnership
subcommittee is focused on identifying and building partnerships, quite
possibly on an ad hoc or informal basis, whereas more enduring and formal
partnerships remain in the domain of the full Board and ATSA administration.
Finally, the in-reach
subcommittee has the goal of outreach within ATSA (hence the name of the
subcommittee). This subcommittee developed the recent membership survey
(described below) and is focused on ensuring strong communication between the
JPC and ATSA membership. Additionally, the subcommittee is working to develop a
set of juvenile practice webpages embedded within the ATSA website that will
provide links to juvenile practice materials and information, as well as a
contact page for members who wish to contact the juvenile practice
committee.
Other Committee Work
We’ve formed a small working group to review ATSA’s 2006 Report of the Task Force on Children with
Sexual Behavior Problems, with the goal of revising or updating the report
if necessary. In addition, the JPC has just begun working on a cross collaborative initiative
with the Public Policy Committee on juvenile sex offender registration.
Membership Survey
As many will know, the juvenile practice committee (through
the in-reach subcommittee) recently asked the ATSA membership to complete a
brief survey. We received 369 responses, which represents about 12 percent of ATSA membership - so
thank you very much! Four survey multiple-choice questions were asked, each of
which additionally provided an opportunity to enter comments, although these
were limited in length. A fifth “open” question, allowed for additional general
comments, also with a limitation in length.
Question one asked how
membership envisioned the role/purpose of the juvenile practice committee.
Among the responses, most felt that they wanted the JPC to keep membership
updated about ATSA policies, papers, and resources; preparing and making
available best practices materials and resources; disseminating the adolescent
practice guidelines and keeping these updated and dynamic; and periodically
pointing to significant articles addressing juvenile practice.
With respect to question
two, asking how the JPC can be of greatest value, the most common response
was to notify membership about resources or matters that influence juvenile
practice, and secondarily providing periodic updates about what the juvenile
practice committee is up to.
Question three asked how the JPC can
best communicate with membership. Most
responses suggested a website
presence within the ATSA website and a regular spot in the Forum.
Question four asked about frequency
of JPC communication to membership in general, and the most common response was
quarterly or more frequently if there is something specific to communicate.
The final question,question five, was actually not a question at all, but instead provided
an opportunity for thoughts or comments (limited in length), and provided a
range of responses.
Of course, the
survey results, including comments, are too detailed to include here, but this link will take you to a
more detailed summary that will give a clearer sense of responses. Happily, as
I hope this brief article describes, the JPC is already engaged in or on the
way to engaging in many of the activities and initiatives described in survey
responses.
Meet Us at the 2018 Annual Conference
The juvenile
practice committee held a “meet-and-greet” at the 2016 ATSA conference, and
we’ll be doing this again at this year’s conference in Vancouver. If you’re
attending the conference (and we hope you are), mark your calendars to join us
on Thursday, October 18 from 5-6 pm. We’ll begin with a 10-15 minute
overview of the committee’s work and goals, and then be available to answer
questions, meet conference participants, and build contacts and connections.
The conference
looks excellent and has plenty of offerings for those working with young
people. A glance at the conference brochure shows at least 16 pre-conference seminars
focused on work with youth, including those applicable to adults or youth, and
at least 57 conference workshop sessions on Thursday and Friday aimed at
youth work or work with adults and
youth. Hope to see you there!
Wrapping Up
We don’t yet have a contact page set up on the ATSA website,
but if you have any questions about the juvenile practice committee feel free
to contact the committee chair, Phil Rich: phil@philrich.net.
The ATSA Adult Clinical Practice Committee
Anita Schlank
The Adult Clinical Practice Committee serves as a resource for
providers who treat adult males who have sexually offended. The mission of the committee includes updating
treatment providers about ATSA policies and papers, updating the Practice
Guidelines for the Treatment of Adult Male Offenders, and disseminating new
relevant research.
History and Membership:
The Committee began in 2014, but has undergone several membership
changes. The first Chair of the
committee was Jennifer Wheeler, followed by a brief period chaired by Pamela
Yates. The current co-chairs of the
committee are Anita Schlank and Shan Jumper, both Clinical Directors of SVP
programs, with Anita directing the Virginia program and Shan directing the
Illinois program. Members of the
committee include Adam Deming (Executive Director at Liberty Healthcare in
Indianapolis, Indiana), Jill Levenson (Professor of Social Work at Barry
University in Miami, FL), Anton Schweighofer (private practice in Burnaby B.C.),
Carla Xella (private practice in Rome, Italy), and ATSA’s Executive Director, Maia
Christopher. Pamela Freske (Associate
Director of Behavioral Health for the Minnesota Department of Corrections in
Minneapolis) and Amber Lindeman (private practice in Minneapolis, MN) are
rotating off the committee, and Deirdre D’Orazio (private practice in
Atascadero, CA) has just joined.
Membership Survey:
In early 2017, a survey of the membership was conducted to determine
how the Adult Clinical Practice Committee could be of the most benefit. 260 members responded to the survey and
indicated that they would be interested in the committee providing additional
information and resources about several topics, with the top five topics being
Internet & Child Porn Offenders, Assessing Treatment Needs and Change,
Risk-Needs-Responsivity, The Self-Regulation Model, and Group Therapy
Techniques. Within the topic of
responsivity issues, members noted that they were most interested in a focus on
Psychopathy, Trauma-Informed Care, Treatment of Denial and Intellectual
Functioning. Members responding to the
survey indicated that their preferred method for obtaining this information would
be through free webinars, followed by a dedicated page on the ATSA website and
a special column in the ATSA Forum.
Results of this survey have guided the work of the committee.
Committee Work:
In addition to reviewing the Practice Guidelines to determine if
revisions are needed, the committee has begun work on several other
projects. Several short, videotaped lectures are being
developed on various topics to be made available for free to ATSA members from
the Members Section of the website. Scheduled
to be filmed are Bob McGrath on Effective Aspects of a Sex Offender Program,
Steve Sawyer on Group Process, and Sandy Jung on understanding the Risk Needs
Responsivity Principles. Committee
members are also working to develop links to available articles on various
treatment-related topics. These links
will assist those who quickly desire to catch up on relevant research and other
publications in certain areas. Links
have already been created to direct members to the available articles on the topics
of Group Process, Treating Denial, Assessment and Treatment of Deviant Arousal,
and use of EMDR. These links, along with
the videotaped lectures will soon be posted to a dedicated “Clinician’s Corner”
section of the ATSA website. Most
recently, the Adult Clinical Practice Committee has been tasked by ATSA’s
President to begin development of guidelines for institutions when evaluating
and/or choosing programs.
If you have ideas about how the committee can be a more helpful
resource for treatment providers, please contact Anita at anita.schlank@dbhds.virginia.gov. Or meet us at the 2018 Annual
Conference. Mark your calendar for
Thursday October 18, 2018, from 5 pm – 6 pm in the Constable room, and join us
for a joint meet and greet with the Adolescent Practice Committee.
The ATSA Student Experience: A Personal Anecdote on Attending the Conference and Joining the Student Committee
Carissa Toop
As an undergraduate student it was recommended
to me by my supervisor, Dr. Sandy Jung, that I attend the ATSA conference. At
the time, I knew very little about the field of sexual abuse, but was excited
about the opportunity to attend my first international conference. I had little
idea of what I could expect, including whether I would enjoy taking part in
academic conferences. Fast forward five years and I have yet to miss an ATSA
conference – I am hooked! Each year, I look forward to the ATSA conference and
all that is has to offer. The opportunities for students are endless. In
addition to high calibre presentations and workshops, the ATSA conference
provides numerous student-focused networking events. My personal favorite is
the Next Generation Reception – a
laid back environment where students have the chance to meet well-known
researchers whose work inspired them to attend the conference in the first
place (and did I mention there is also free food!). Through these
opportunities, I have made a number of meaningful professional contacts and
acquired a passion for research pertaining to sexual abuse. Each year I look
forward to reuniting with the friends and colleagues I have met at ATSA and
discussing the latest developments in the field and new ideas for
research.
After a few years, I realized how much the ATSA
conference had given me and I wanted to give back by becoming more involved in
the behind the scenes work. For me, this meant becoming involved with the ATSA Student Committee. The
principle objective of the ATSA Student Committee is to support the next
generation of professionals dedicated to preventing sexual abuse. To do this, the committee oversees a
number of different operations and events that make this conference inclusive
and meaningful for students including:
- The Student Clinical Case and Data
Blitz – a symposium
consisting of rapid, 5-minute presentations examining important issues
related to the prevention, assessment, management, and treatment of individuals
who engage in non-consensual sexual behaviours. This event primarily features
student presenters, allowing students to obtain experience presenting in a
symposium format at an international conference. ATSA 2018 will host the 5th
Annual Student Clinical Case and Data Blitz. All are welcome to attend this
year’s event during the Thursday Concurrent Program (T-27; October 18th,
2018 from 1:30 – 3:00pm).
- Student Poster Awards – during the poster sessions, high
quality research and visual presentation is recognized through two awards. A
prize is available for the top student poster of each poster session. Newly
graduated professionals are also eligible for these awards if their research
had been completed while they were a student. This year’s poster sessions will
be held on Thursday, October 18th, 2018 and Friday, October 19th,
2018 from 5:15 – 6:00pm.
- Next Generation Reception – the reception is a “backstage
pass” designed to connect student attendees with leaders in the field. This is
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 event is open to students attending the
ATSA conference and will be held this year on Thursday, October 18th,
2018 from 6:30 – 8:00pm. Important:
This event requires an invitation and thus, if you have not already done so
please send your RSVP to Kelly McGrath at kelly@atsa.com
- Preparing the Next Gen Workshop – This past conference, the ATSA
Student Committee hosted a free half-day preconference workshop focused on developing
professional skills critical to a successful career. Due to its popularity,
this workshop is returning for the 2018 ATSA Conference as a FULL-DAY preconference workshop FREE for students. It will be held on
Wednesday, October 17th, 2018 from 8:30am – 5:00pm.
In recent years, under the guidance of ATSA Student Representative Andrew Brankley, these events and other
critical tasks have been divided among a group of dedicated students who share
the same passion about ATSA as I do. It was a highly rewarding experience to
see these successful student events unfold at ATSA 2017 in Kansas City knowing
that I played a role in helping accomplish this. If you are a student who
enjoys ATSA and is interested in getting more involved I highly encourage you
to consider joining the ATSA Student Committee. For more information regarding the
Student Committee please contact Andrew Brankley, ATSA Student Representative, at Andrew.brankley@psych.ryerson.ca
I look forward to seeing you all at ATSA 2018 in Vancouver!
Carissa Toop
--
Carissa
Toop, B.A. (Hons.) is a graduate
student of Clinical Psychology at the University of Saskatchewan. Prior to her
graduate training, she earned a bachelor’s degree (honours) in psychology from
MacEwan University. Broadly speaking, Carissa’s research and clinical interests
lie in the assessment and treatment of sexual and non-sexual violence. She has
published and presented on the topics of risk assessment, intimate partner
violence, and sexual offending, and is a member of the ATSA Student Committee.
Carissa is currently completing her doctoral degree under the supervision of
Dr. Mark Olver. Her dissertation research will focus on the application of the
Violence Risk Scale (VRS), a multi-purpose risk assessment tool, to intimate
partner violence.
Two by Jeglic and Calkins
Submitted by David S. Prescott, Forum Review Editor
These two reviews focus on two professors of psychology at
John Jay College and prolific contributors to our field, Elizabeth L. Jeglic
and Cynthia Calkins. Jeglic and Calkins are each on the Editorial Board of
Sexual Abuse, also known by members as “The ATSA Journal.” The first is an
edited volume intended for a scholarly audience, while the second is for a
general audience readership (primarily parents and teachers) interested in
protecting their children.
Sexual Violence:
Evidence Based Policy and Prevention
Elizabeth L. Jeglic
and Cynthia Calkins, Editors
2016: Springer, New
York
336 pages, USD
$138.00
Policy and prevention have long been a primary interest of
ATSA members, with the organization focusing for many years in these directions
through its committee work, amicus briefs, white papers, etc. This edited
volume serves as a “who’s who” of researchers in the field of policy and
prevention. It is an excellent follow-up companion to the ATSA task force
report edited by Keith Kaufman in 2010 and published in collaboration with
NEARI Press.
Jeglic and Calkins start the volume off with an overview of
the issues addressed in subsequent chapters without summarizing their
highlights. Brandy Blasko provides an overview of considerations regarding the
typologies, recidivism, and treatment of people who have sexually abused. In
some cases, the use of historical language may be surprising (e.g., situational
versus preferential child molesters), but Blasko’s intent is to provide a
historical framework that serves as a springboard to what follows.
Policy chapters focus on the Sex Offender Registration and
Notification Act (Kristen Zgoba and Deborah Ragbir), residence restrictions
(Jill Levenson and Claudia Vicencio), civil commitment (Michelle Cubellis and
Andrew J. Harris), Internet sexual offender laws (Ashley Spada), and the use of
electronic monitoring as a supervision tool (Stephen V. Gies). Each chapter is
well-researched, often by the acknowledged leaders in the field (e.g., Jill
Levenson on residence restrictions). In some cases, there may have been a
slight over-reach in attempts to place each topic in context (there is, for
example, a discussion of castration in the chapter on electronic monitoring
that may appear out of place), but the overall result is above reproach: each
chapter extends beyond what one might find in the literature reviews of
scholarly journal articles. Indeed, some chapters are themselves extended
studies.
The second half of the volume focuses on prevention and
includes chapters on public health approaches to preventing sexual violence
(Ryan Shields and Kenneth Feder), situational approaches (Stephen Smallbone),
community-level approaches (Sarah DeGue, Tracy Hipp, and Jeffrey Herbst),
measuring the outcomes of prevention programs (Gwenda Willis and Natalie
Germann), a social norms change approach to prevention (Elizabeth Miller and
colleagues), proactive strategies to prevent child abuse and the use of child
abuse images – the Dunkelfeld Project (Klaus Beier), providing help to young
men who are sexually attracted to children (Luke Malone), the use of civil
commitment in prevention (Eric Janus), and the economics of policy and
prevention (Anthony Perillo).
As one might expect, the writing and editing make for an
easily accessible read, especially for those professionals in areas (such as
treatment provision, education, or research) that have an interest in policy
and/or prevention. It is an excellent opportunity to catch up on projects (such
as Dunkelfeld) and various authors and their perspectives (Eric Janus has
written entire books in the area of civil commitment). Likewise, it provides
newer perspectives and information (Willis and Germann’s chapter on outcomes
and their implications being a prime example).
In the end, the authors and editors are clear in their
assessments (e.g., residence restrictions “are a failure”) and recommendations.
Although more expensive than other volumes, it provides the best overview of
the issues to date in a single book.
Protecting Your Child
from Sexual Abuse: What You Need to Know to Keep Your Kids Safe
Elizabeth L. Jeglic
and Cynthia Calkins
2018: New York,
Skyhorse Publishing
158 pages, USD $8.99
Jeglic and Calkins teamed up for this volume in the wake of
the above academic project. Available in print and electronic forms, this
smaller volume provides a needed overview for parents. It is comprehensive
without becoming overbearing and will find a different audience than previous
works by authors such as Melissa Pirwani and the late Jan Hindman.
The structure and writing are user-friendly and informative.
Professionals in the field (including those in child welfare as well as those
assessing and treating abuse) can use this as a reference for parents. It moves
from an overview of myths and realities into what one can expect from sex
offender registries. It then focuses on how to start difficult conversations
and addresses the limitations of the well-known “good touch bad touch”
approach. From there, the volume turns into the direction of online dangers and
the perennial question of whom one can trust in these situations. The authors
then follow a developmental pathway, from talking to your tween, to talking to
your teen and finally the college years. The book concludes with an excellent
overview of ways that readers can help their communities to stop sexual
violence and provides questions for group discussions.
Armed with the knowledge described earlier, the authors were
almost uniquely poised to produce this book. It is an excellent resource, plain
and simple.
The Safer Society Handbook of Assessment and Treatment of Adolescents Who Have Sexually Offended
Review Submitted by Becky Palmer, MS
Edited by Sue
Righthand, PhD and William D. Murphy, PhD.
Professionals who have provided clinical
services to adolescents or have parented adolescents know just how quickly teens
change and grow. So it is with the field of assessment and treatment of
adolescents who have sexually offended. Many years ago, the assessment and
treatment programs for adolescents were often pared down versions of what was
being delivered to adult sex offenders. Developmentally we know that teens are
different than adults, they are still growing and changing. This specialization,
in the past, while wanting to attend to the needs of teens and their families,
didn’t always get it right. In the very early days, adolescents who had
committed sexual offenses were treated as criminals and questioned like adults.
What we know and understand about adolescents who have sexually offended has increased
many fold over recent years to better meet the needs of these youth.
Sue Righthand and Bill Murphy, who have
co-edited this compendium, have gathered a cadre of experts in the field, to
author numerous chapters which shed light on what is currently best practice for
adolescents who have committed sexual offenses.
What the reader will find in these five hundred
and thirty-one pages are fifteen chapters dedicated to helping professionals
understand the recent best practices as they relate to adolescents who have
sexually offended. This book is divided into four sections: Part I Characteristics of Adolescents Who
Sexually Offend consists of four chapters outlining adolescent development,
the legal implications for youth who sexually offend, the search for
distinctive features of juveniles who sexually offend and the life course view
of juvenile sexual offending. Part II
Assessment dives into forensic assessments of juveniles as well as the best
clinical approaches for high quality assessments. And lastly in this section, an
excellent chapter identifying risk assessment tools that have historically been
used to assess risk. This chapter identifies the categories that need to be
covered and addressed in the youth’s risk assessment report. Part III Intervention outlines how best
to engage the adolescent and family into the treatment process, what is
currently evidence-based practices and treatment and the many considerations
for community reentry and family reunification. While this section doesn’t explain
how to do therapy, each author has been diligent to provide a multitude of
references for the reader. Part IV
Special Issues is mindful to direct the reader to consider the assessment
and treatment of youth with developmental disabilities as well as how trauma
impacts the mental health concerns of each youth in treatment. Importantly, in
this section adolescent females who sexually offend is being addressed and
helps the reader to identify the different treatment and assessment needs.
Bringing us into the 21st Century the chapter on pornography use and
youth produced digital images among adolescents will be most helpful to treatment
providers. Any book about adolescents who sexually offend is not complete without
addressing the policy issues surrounding the criminological perspective.
Co-editors Righthand and Murphy have chosen
authors whose expertise is providing the reader with historical context and
moving into current best practice. The reader should not be disappointed that
this book is not a “how-to” do assessment and treatment of adolescents who have
sexually offended but should revel in the fact they have been provided a sound
framework of theory, history and insight into what a responsible and ethical
practitioner needs for delivering competent treatment and assessments for youth
and their families.
Readers can certainly expect to find robust
bibliographies at the end of each chapter. Each author has done an excellent
job of outlining the needs of youth who have sexually offended and each reader
will be pleased to have this book to refer to when updating their knowledge and
practice, or redesigning existing programs to meet the needs and challenges of
working with adolescents who have sexually offended.
2018 ATSA Conference Events
WEDNESDAY
Networking
Event
Wednesday,
Thursday, Friday, October 17, 18, 19 | 7:45 am – 8:15 am
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. All are welcome!
2018 Public
Policy Reception
Wednesday, October 17 | 5:00 pm – 6:00 pm
Interested in registry reform?
Government policies that impact the work we do? Becoming more involved in
ATSA's public policy activities? Then join the ATSA Public Policy Committee
(PPC) for an informal reception to learn more! An open forum meet-and-greet
with no host bar. The event is open to all conference attendees.
Opening Reception
Wednesday, October 17 | 6:00 pm – 9:00 pm
Come and greet old friends, welcome
first–time attendees, and renew your spirits. This evening features an
introduction to Vancouver hospitality, great food, and a well-deserved
opportunity to celebrate! Casual attire suggested. All conference registrants
are welcome!
THURSDAY
Networking
Event
Wednesday,
Thursday, Friday, October 17, 18, 19 | 7:45 am – 8:15 am
Special Movie Screening
"Coming Home"
Thursday, October 18 | 5:30 pm – 7:30 pm
This film by Bess O'Brien focuses on
five people returning back to their Vermont communities from prison and the
innovative COSA program (Circle of Support and Accountability) that helps
reintegrate folks back into their daily lives. The COSA program is run through
Vermont’s Community Justice Centers and is part of the restorative justice
model. Discussion to follow led by Derek Miodownik of the Vermont Department of
Corrections.
Thursday Plenary
Session
Ruth E. Mann, PhD
Being Evidence–Based
Thursday, October
18 | 9:00 am – 10:00 am
Ruth was head of HM Prison Service’s Sex
Offender Treatment Programme between 1994 and 2011. Since this time, Ruth has been
seeking a better understanding of the nature of evidence– based policy and
practice in correctional settings. Some of the challenges she has encountered
include deciding when evidence is of sufficient quantity and quality;
overcoming confirmation bias and correctional quackery; and re–assessing
practice when an approach believed to be evidence–based is evaluated and did
not work. in this presentation Ruth will illustrate these challenges and suggest
some tactics for surviving them.
ATSA Adult Clinical
& Juvenile Practice Committees Meet–And–Greet
Thursday, October 18 5:00 pm – 6:00 pm
The adult Clinical and juvenile Practice
committees invite conference participants to meet members of the committees for
an informal meet–and–greet. We will begin with a 10–15 minute overview of the
committee’s work and goals, and then be available to answer questions, meet
conference participants, and build contacts and connections. We hope you’ll
join us!
FRIDAY
Networking
Event
Wednesday,
Thursday, Friday, October 17, 18, 19 | 7:45 am – 8:15 am
Friday Plenary Session
Gerald Oleman
An Indigenous
Perspective on healing for Sexual Offenders
Friday,
October 19 | 9:00 am – 10:00 am
This
presentation will create understanding for all practitioners involved with indigenous
clients. In my experience as a practitioner, I have found that many indigenous
clients will not participate in counselling and treatment offered to them. I
have known survivors of residential school that were referred to therapy and
after their first session would not return to therapy. I inquired why and they responded
that the therapist did not understand them. Using indigenous methodology I have
had success with individuals and families. The hope is to create a collective
endeavor to build programs that are culturally relevant and to share
alternative methods I have used successfully. The question is, “can indigenous
methods meld with orthodox therapeutic modals?” I believe that if we put our minds
together, we can create successful programing on healing for our clients.
SATURDAY
Saturday Plenary
Sessions
Robert
J. McGrath, MA | R. Karl Hanson, PhD, CPsych
How
Much Intervention Is Enough?
Saturday,
October 20 | 9:00 am – 10:00 am
Individuals with a history of sexual
offending are often considered to have a lifetime, enduring propensity to
commit sexual crime. There is, however, a growing body of research showing predictable
declines in the risk for sexual recidivism based on risk and needs, normal aging,
and the amount of time spent offense free in the community. instead of being
exceptional, desistance appears to be the norm. Consequently, we could benefit
from having a common language about how to communicate risk and needs, consider
how best to facilitate naturally occurring desistance, and consider the point
at which our interventions no longer meaningfully promote public safety.
Join us in listening to Robert McGrath's
conversation with Karl Hanson as they discuss his research and its implications for risk assessment.
Erick
Janssen, PhD
A
Myriad of Forces: The Impact of Sexual Arousal and Other Emotions on Sexual Behavior
and Decision Making
Sexual arousal is a motivational state and emotion
that can impact behavior and decision making. it interacts in complicated ways
with other emotions, including anxiety and sadness, and is under the control of
both excitatory and inhibitory processes. i will present recent findings of questionnaire
and psychophysiological studies examining the complex nature of the
relationship between sexual and nonsexual emotions and of research on the
effects of individual differences in the propensity for sexual excitation and
inhibition on sexual response, function, and behavior, including hypersexuality
and sexual aggression.
Download the 2018 Conference Brochure.
Public Engagement Event
Welcome Incoming Board Members
Congratulations to our newly elected and appointed Board Members.
Shan Jumper
Rushville, Illinois
President-Elect
2019-2022 |
Katherine Gotch
Portland, Oregon
Public Policy Representative
2019-2021 |
Jeffrey Sandler
New York, New York
Research Representative
2019-2021 |
Ainslie Heasman
Toronto, Ontario, Canada
Treasurer
2019-2021 |
To nominate yourself or a colleague for the ATSA Board, submit your nominations beginning in March, 2019.
The following positions will be available for nomination for the 2019 Election:
Elected
Representatives:
Appointed Representatives:
2018 ATSA Awards
In recognition of those who have made significant contributions to our mission of managing individuals who sexually offend and to the prevention of sexual violence through research and treatment, the ATSA Board of Directors will announce the recipients of this year’s awards. in addition, ATSA’s Board of Directors will announce the recipient of the Graduate Student Research award and Research Grant selected from submissions by graduate students who have completed research focusing on either sex offenders or sexual abuse victims.
Join us for the award presentations at the 2018 ATSA Conference on Thursday October 18 and Friday, October 19, 8:30 am – 9:00 am in the Hyatt Regency Ballroom, Vancouver, BC, Canada.
Lifetime Significant Achievement Award
Michael C. Seto, PhD, CPsych
Dr.
Michael C. Seto's applied and theoretical contributions directly
influence what we understand about the onset of sexual offending,
primary prevention and the deterrence of sexual offending as well as
persistence in offending, risk assessment, online offenders and child
sexual abuse imagery. encouraging growth and debate, Dr. Seto’s openness
and willingness for critical analysis of his own work and of others’,
his sharing of research through multi-media avenues, and his mentoring
and support of students gives much credit to broadening our field and is
vital to encouraging growth and debate within the field. His work has
directly influenced, and will continue to, how we assess and engage in
treatment with individuals who have committed sexual offenses, how we
work with their families and victims, and how we can best protect our
communities. With over 10,000 citations of over 80 articles, two solo
authored books, 28 chapters, and hundreds of presentations, Dr. Seto’s
prolific and accomplished research record will continue his effect on
our field for years to come.
|
Gail Burns-Smith Award
Joann Schladale, MS
Joann Schladale is the founder and executive Director of Resources
for Resolving Violence, a mental health agency that provides in-home,
trauma-informed services. She facilitates trainings for therapists, law
enforcement officers, advocates and other professionals on topics
including intra-familial sex offenders and youth with sexual behavior
problems.
For over 30 years, Joann has been transforming the lives of victims,
perpetrators, family members and professionals with innovative
strategies and compassion within the fields of sexual and domestic
violence. Often referred to as a guiding light in the career of
professionals she has given trainings to, Joann Schladale’s trainings
have shaped trauma informed and restorative approaches and processes,
providing empowerment and a renewed passionate about the work we do.
|
Student Research Awards & Grants
|
Graduate
Research Award
Sarah
Paquette, PhD Candidate
The Development
and Validation of the Cognitions of Internet Sexual Offending (C-ISO) Scale
|
Pre-Doctoral
Research Grant
Rebecca L.
Dillard, MSW
Maltreatment,
Emotional Responses to Abuse, and Trauma Among Adolescents Engaging in Sexual
or Non-Sexual Delinquency |
New ATSA Members
The following ATSA members were approved for Membership from June to September 2018.
Denise
Ackermann, LCSW
Indianapolis, IN |
|
Shawndre Jones, MA
Arcadia,
FL |
Elisha Agee,
Psy.D.
Charlottesville, VA |
|
Peter Kuhns, Psy.D.
Durham, NC |
Scott Altamirano,
LMFT
Santa Rosa, CA |
|
Desiree LaBlanc, MPA, CADC
Des Moines, IA |
Alexander Andersen,
LPC
Laramie, WY |
|
Dory LeClair Lippert, MSW, LCSW
Henderson, NV |
Anthony Andrews,
LPC
Charlotte, NC |
|
Patricia Ledoux, M.S. Psychology
Biddeford, ME |
Alisa Anthony, M.S.
Little
Rock, AR |
|
Charles Lenahan, M.A., LAPC, NCC, CSOTS
Tyrone, GA |
Patrick Aron,
LLPC
Cadillac, MI |
|
Sean Lennon, LMHC
Jamestown, NY |
Kristin Austin, MSW, APSW,
CSAC,ICS, LCSW (Temp)
Janesville, WI |
|
Laura Levin, LCSW
SANTA ROSA, CA |
Laurie Barnes, LPC
Evart,
MI |
|
Nickole Long-End, Masters
La Grande, OR |
Brianna Bartels Rohrbeck,
Ph.D.
Waupun, WI |
|
Matthew Lorenz, MS, AJS-GHS
Evart, MI |
Lisa Bauschelt,
LMSW
Phoenix, AZ |
|
Shakti Giulietta Madrigal-Pingol, MA, LMFT
Santa Rosa, CA |
Shauna Bean, BS,
JD
Silvana, WA |
|
Loretta Manning, LPC
Stockbridge, GA |
Robert Beattey, Jr., JD,
PhD
Long Beach, CA |
|
Larry Marshall, LPC
St. Charles, MO |
James Besson,
Psy.D.
Waupun, WI |
|
Jonathan Mason, LCSW
Eatontown, NJ |
Erin Bickley, M.S., LAPC,
NCC
Tucker, GA |
|
Kirsten Mason, PsyD
Bakersfield, CA |
Kelley Blackwell,
LMFT
Waverly, TN |
|
Merri P. McCarthy, LGSW
Bemidji, MN |
Ian Blair, LCSW
Kalamazoo,
MI |
|
Wendy McGinnis, Ph.D.
Mitchellville, IA |
Leonardo Bobadilla,
Ph.D
Hillsboro, OR |
|
Colton McNutt, PsyD
Canon City, CO |
Bradley Boivin,
Psy.D.
Janesville, WI |
|
Jose Mejia, MD, PhD FRCPC
Halifax, Nova Scotia, Canada |
Joy Boston, B.S.
Psych.
Bemidji, MN |
|
Karina Mellen, BS
Bemidji, MN |
Etta Brodersen,
PhD
Dartmouth, Nova Scotia, Canada |
|
Susan Mills, Dpsych (Forensic)
Launching Place, VIC,
Australia |
Terry Jo Brooks-Devlin, NP
Psychiatry
Rochester, NY |
|
Kathleen Moore, M.Ed.
Indiana, PA |
Selyna Brown, MSW
Kingston,
NY |
|
Brooke Morse-Karzen, Psy.D.
Joliet, IL |
Kelsey Burrows,
M.A.
Anchorage, AK |
|
Sarah Moss, MSc.
Halifax, Nova Scotia, Canada |
Kristin Carlson,
Ph.D.
Tacoma, WA |
|
Janice Munson, MA, LMSW, British ColumbiaBA
Woodward, IA |
Emily Carter, LCSW,
LSOTP
Chicago, IL |
|
Jean-Claude Nicolas, LMSW
Middletown, CT |
Sumeeta Chatterjee,
MD
Toronto, Ontario, Canada |
|
Chris Nordstrom, LCSW
Missoula, MT |
Mary Jeanne Chavez, MSC,
LAC
Tucson, AZ |
|
Mehrnaz Peikarnegar, M.S.W.
Vancouver, British Columbia,
Canada |
Ashok Chhabra, Psy.D.
Camp
Hill, PA |
|
Gary Ralph, D.O.
Grand Rapids, MI |
Vivian A. Clark,
MSW
Charlotte, NC |
|
H. Elise Reeh, PhD
Mission, British Columbia, Canada |
Jessica Conroy, PhD, LMHC,
MCAP
Ocala, FL |
|
Mavis Ring, Psy.D.
San Jose, CA |
Christi Cooper-Lehki,
D.O.
Morgantown, WV |
|
Jennifer Ritchie, J.D.
Seattle, WA |
Elyse Crosswell, MPsych
(Forensic)
Melbourne, VIC, Australia |
|
Jonathan L. Rosario, Psy.D.
Moose Lake, MN |
Carla
Dassinger, Registered Clinical Psychologist
Mission, British Columbia,
Canada |
|
Kathryn Ross, JD
Seattle, WA |
Keith Davis, Psy.S.
LSP
Woodward, IA |
|
William Ross, Ed.D.
Houston, TX |
Jamie Declercq, MSW,
LISW
Lima, OH |
|
Angela Rushmeyer, B.A.
St. Cloud, MN |
Mary Denning,
LMSW
Holdbrook, NY |
|
Erica Rutledge, LPC/I
Piedmont, SC |
Michael Dolan, MA
Brevard,
NC |
|
William R. Samek, Ph.D.
MIAMI, FL |
Shawn Duffee,
Ph.D.
Jefferson City, MO |
|
Deborah Newby Sapp, MSSW
Huntsville, TX |
Abigail Eck,
M.A.
Huntsville, TX |
|
Jamie Saunders, LMHC
Gainesville, FL |
David Ejchorszt,
LMSW
Meridian, ID |
|
Aiden Schermerhorn, BA
Bemidji, MN |
Erika Elkins
Waukegan, IL |
|
Dawn Schiro, LCSW, BACS
Slidell, LA |
Robert J. Elsen, LPCC
St.
Peter, MN |
|
Michelle Schmid-Egleston, M.A., LP
Red Wing, MN |
Abigail Finch,
LCSW
Mishawaka, IN |
|
Jacquelyn Shair, MBA, MS
Huntsville, TX |
Micah Fleitman, MA
Fairfax,
VA |
|
Molly Shepard,
Palo Alto, CA |
James Fonti,
L.M.S.W.
Farmingdale, NY |
|
Daria Shewchuk, PhD Clinical Psychology R. Psych.
Surrey,
British Columbia, Canada |
Shaquera Fowlkes, MA, MA,
LP-MHC, CASAC-T
Brooklyn, NY |
|
Connie Shlimovitz, MA Ed
Mauston, WI |
S Joy Fox, PsyD,
LPC
Denver, CO |
|
Velda Simmons, Master/LCASA
Charlotte, NC |
Carol Franklin, LMHC,
LCAC
indianapolis, IN |
|
Ahvegyil Skolnick, MSW
Poughkeepsie, NY |
Maricruz Garcia,
LMHC
Brooklyn, NY |
|
Kelly Slaven, LCSW Supervisor
Dallas, TX |
Sharon Gingola,
LCSW
Liberty, NY |
|
Barbra Spotts, MSC/CCMH, MS/P
Phoenix, AZ |
Deborah Given,
LCSW
iRVINGTON, NY |
|
Margot Stanhope, LMHC
Bradenton, FL |
Victoria Gonsalves,
LMHC
Kew Gardens, NY |
|
Una Starr, MH352
Honolulu, HI |
Karin Gorseth, LCSW
New
York City, NY |
|
Eli Stoll, M.S.
Terre Haute, IN |
M. Michelle Gourley, MFT,
LCSW, JD
Salt Lake City, UT |
|
Kelli Thompson, Ph.D.
Auburn Univesrsity, AL |
Sophie Grahame,
MSW/RSW
Pilot Butte, SK, Canada |
|
Robin Thompson, M.Ed., British ColumbiaBA,
LABA
Badwinville, MA |
Krystal Gray
Elkhorn, WI |
|
Antonia Tombari, M.A., LMFT, CCSOTS
Spokane, WA |
Meghan Grout,
LPC
Middletown, CT |
|
Leonard Uchendu, LMSW
Jackson, MI |
Sally Gulmi, M.Ed
Barre, MA |
|
Agnes Venson, CSOTP
Fairfax, VA |
David Hall, MSW
Watertown,
NY |
|
Olga M. Viera, Psy.D.
Orlando, FL |
Patti Harmer, MS
Carlsbad,
NM |
|
Stephanie Wachter-Papenfuss, MS, LPC, SAC
Mauston, WI |
Winnie Hatcher,
Olympia, WA |
|
Deborah Waldinger
Antrim, NH |
Cheryl Heimann,
LCSW
Norfolk, NE |
|
John Walker, MSW
Etobicoke, Ontario, Canada |
Jennifer Helsel,
LLPC
Evart, MI |
|
Cassidy Wallis, B.A.
Kelowna, British Columbia, Canada |
Angela Hiebsch, MS
Bemidji,
MN |
|
Sandy Walls-Tustin, master's in counseling
psychology
Poteau, OK |
Paul Hoard, Ph.D.,
LCPC
Olathe, KS |
|
Cathy Walters-Gilhuly, M.S.W., R.S.W.
Guelph, Ontario,
Canada |
Elizabeth Hoel
Mesa, AZ |
|
Cassandra Wayterra, MSW, LMSW
Mesa, AZ |
Chester Hoernemann
Glencoe,
MN |
|
Rachel Webb, LCSW
Ithaca, NY |
Brian Holoyda, M.D., M.P.H.,
M.B.A.
St. Louis, MO |
|
Eugene Wells, LCSW
Forest Hills, NY |
Catherine Howson,
M.A.
Hamilton, Ontario, Canada |
|
Nicole Wildroudt, MS, CDCA II
Trotwood, OH |
Katherine Huncovsky
Las
Vegas, NV |
|
Julie Williams, MSEd, LMHC
Tampa, FL |
Kristi Hunziker,
MSW
Yakima, WA |
|
Sally Williams, Psy.D.
Fox Lake, WI |
Russell Hyken, PhD
St.
Louis, MO |
|
Tawny Williams
Elk Grove, CA |
Maggie Ingram,
MHS
Baltimore, MD |
|
Jeffrey Woodward, BS
Evart, MI |
Daniella Jackson, Ph.D.,
LMHC
New Port Richey, FL |
|
Jonathan Young, B.A.
Pekin, IL |
LuAnn Jefferson, LPC,
LCAS
Arden, NC |
|
Leslie Zanette, M.Psy
Vancouver, British Columbia, Canada |
Kimberly Johnson,
PsyD
Oakdale, CA |
|
|
|