ATSA Forum

Vol. 34, Issue 3
Summer 2022

Farewell Letter to Maia

by Shan Jumper, Ph.D.

In July we say goodbye to long time ATSA Executive Director Maia Christopher.  In this farewell letter it seems fitting to use some of the poignant words ATSA members shared publicly following the announcement of Maia’s transition to tell the story of and pay tribute to Maia’s long and dedicated service to our organization.  We are also exploring additional options to honor Maia’s legacy.

The average tenure for an Executive Director of a non-profit organization is approximately six years.  ATSA has been blessed with Maia’s strong leadership for 15 years.  Maia’s executive skills are a huge part of ATSA’s ongoing financial stability.  She became incredibly adept at conference planning and implementation, with virtually every conference under her leadership generating a meaningful profit for the organization. 

Maia’s service to ATSA actually began several years prior to her moving into the Executive Director position.  She had previously served on the ATSA Board of Directors and also co-chaired the committee that developed ATSA’s first practice standards, titled “ATSA Standards and Guidelines”.

Maia officially began in her role just before the conference in 2007 during a period of turmoil for the organization following the departure of two short term Executive Directors, neither of whom were a good fit for the organization:

“One can only imagine the challenges of being an Executive Director for ATSA.  We wanted a person competent in administration, management, and organizing a conference while also needing someone with not just an understanding of the field, but a deep appreciation for it. Maia was clearly it. With the help of then-President Robin McGinnis and “Dream Team” member Jacque Page, Maia basically saved the 2007 ATSA conference in San Diego.  This can’t possibly have been easy for anyone involved. Thank you, Maia Christopher, for your service and leadership through all the ups and downs of our organization.”  (David Prescott)

“Once upon a time Maia was one of us working on committees and being a board member and attending conferences along with the rest of us. Then an opportunity arose, and Maia emerged as a leader among us and learned all the ins and outs of conference planning and helping grow our membership and the necessity of having connections with other groups who desired to end sexual violence and prevention of sexual violence. Maia worked tirelessly and I imagine there were times many of us when hearing about ATSA also thought of Maia.  I suspect many of us have spent some time trying our best to craft a remembrance of Maia and the impact she has had on our organization and on our lives.” (Becky Palmer)

Throughout my tenure on the ATSA board I developed a tremendous appreciation for all the effort it takes from the Board, the Executive Director, and the ATSA staff to keep our organization not only running smoothly but also constantly improving and evolving. Maia has projected a natural image of confident and compassionate leadership that helped to define ATSA’s public image:

“Very well said. Thank you for that important history of Maia’s tenure as ED for ATSA and highlighting the numerous ways - too many to count really - in which she has moved ATSA forward and helped shape who we are today!” (Katie Gotsch)

“It was always obvious that Maia was cut from the ATSA cloth. She has been devoted to ATSA, its mission and its future. We have been lucky to have her as our ED for as long as we have. One of the best things about ATSA are the relationships you develop and, although Maia's relationship with ATSA will be changing, we will continue to reap the benefits of having been in relationship with her. I hope her future will also be enriched as a result of her tenure as our ED. I will miss her.”  (Anton Schweighofer)

“Maia has been an exceptional and transformative leader, and she will be sorely missed. I wish her all the best in her future endeavors.” (Sharon Kelley)

“I share everyone's thoughts on Maia's leadership. Having served with her in a few different ways, I have been impressed with her ability to see the details while holding onto the big picture. She has always been so welcoming to me and as others have noted, been able to expand the scope of what ATSA and its mission means to individuals, different professional groups, and the field of sexual abuse prevention as a whole.  Thank you to Maia and the entire Board for all of your leadership!” (Melissa Grady)

"I wanted to echo all the comments about what others have said and add my thanks to Maia. It is amazing to think about all that has happened with ATSA over her tenure. And it takes a certain kind of leader to allow and encourage such innovation. While there have been disappointments as well, I think back over these years and for me, I have seen ATSA take on so much that has been personally meaningful to me. As Karen mentioned, ATSA has carved out a place on the board for a victim advocate, implemented an impressive strategic planning process, fully embraced prevention, dived deeply into the implications of race, power, and privilege in our field and, more recently, committed to exploring how to collaborate in the campus world. And this is all on top of managing an incredible staff, organiz[ing] a large international conference, and [managing] a membership that stretches across the world. As you can tell from my listing I am not a clinician, but ATSA and Maia has welcomed my perspective and contributions. I know that would not be possible without a leader to help make that happen. Thank you, Maia, and wishing you the best in whatever you do next." (Joan Tabachnick)

“Maia's stepping down as Executive Director of ATSA is a significant loss to ATSA. She has been a transformative leader who has changed ATSA's face and direction.  She took over the helm at a time we were floundering with an Executive Director who was uninterested in ATSA's mission and had essentially left us leaderless. Maia not only gave us administrative and managerial stability, but she also gave us direction forward, increasing ATSA's influence and helping to establish our relationships with other organizations seeking to prevent sexual violence.  Under her leadership our committees became more focused and productive. She made ATSA a welcome home for victim advocates and increased our public policy presence and our focus on prevention at every level.  She will be missed.  Congratulations, Maia, on a job well done.” (Ray Knight)

In addition to tremendous appreciation of Maia’s contributions to the organization, another prominent theme of the comments from the membership and the current Board of Directors has been the gratitude many of us feel in relation to our personal connections with Maia.  In addition to her grit, Maia is a fantastic host with a gift for always making the ATSA Board and membership feel welcome and special.  Along with her heavy load of administrative duties, Maia excelled in managing relationships with dozens if not hundreds of ATSA members. This is a less tangible but equally important strength Maia brought to her role as Executive Director, one which clearly showed her commitment to improving our organization and her dedication to enriching the membership experience of every ATSA professional.  Many of us look forward to ongoing relationships with Maia and the well wishes from so many reflect the meaningful ways she has touched our lives:

“I am both saddened to hear of Maia's decision to move on (is there life after ATSA?) and pleased to hear that new opportunities for Maia lie ahead (again, though... is there life after ATSA?). Thanks for all your work, Maia, and the great job you've done with and for ATSA and the strong and focused leadership you've provided, strengthening our organization still further. I'm also very glad for the opportunity to have gotten to know you and build a supportive relationship. I wish you the very best in your new endeavors and whatever lies ahead.”  (Phil Rich)

“I agree with all that has been said and would like to add my thanks to Maia for welcoming me, as a victim advocate, into the ATSA fold. Through your partnership and friendship, I have broadened my knowledge about sexual violence and its prevention and have developed many new friends and valued colleagues in the process. Thank you, Maia - well done!”  (Karen Baker)

“I want to echo the comments made by others as we reflect on Maia’s tenure as Executive Director. I have so many fond memories of serving on the ATSA Board and being able to experience her stewardship.  Thank you for taking such great care of this wonderful organization and each of us. The evolution of this organization under your leadership is quite a legacy. Best of luck in your next chapter.”  (Tom Leversee)

“I want to echo what many others have said.  She has worked tirelessly to move the organization toward its goals, to strengthen ATSA's reputation, visibility and collaborative partnerships, and to navigate through many challenges, both internal and external to the organization.  Maia has also been a good friend to many of us and I am grateful to have enjoyed her friendship and worked with her in many capacities.  I join others in wishing her the very best.” (Robin Goldman)

On behalf of the ATSA Board of Directors, thank you Maia for leaving ATSA in a better place than we were in when you became our Executive Director, and for your 15 years of dedicated service to making the world a better place to live in.  We will miss your presence but look forward to a continued connection for years to come.  Best of luck as you begin the next leg of your professional journey.

Editor's Column

Sharon M. Kelley, PsyD

Welcome to the Summer 2022 edition of the ATSA Forum! This edition’s featured articles have topics ranging from youth and young adults to sex with animals and psychedelic therapy. I’m especially excited to introduce three new authors to the Forum. Kate Walsh, Ph.D. is an Associate Professor in the Gender and Women’s Studies at the University of Wisconsin at Madison. Kate’s work has examined sexual assault on college campuses and trauma. Brian Holoyda, MD, MPH, MBA is board-certified in psychiatry and forensic psychiatry. He is currently employed at the Martinez Detention Facility in Martinez, California. Brian has published on bestiality and other issues pertaining to forensic psychiatry. Natalie Villeneuve, MSW, RSW is a therapist in Etobicoke, Ontario specializing in trauma and sexual abuse prevention. I am also excited that we have two returning Forum authors. Janet DiGiorgio-Miller, Ph.D. is a licensed psychologist with a private practice in New Jersey. She has over 30 years of clinical experience in working with adolescents and family. She is also a current ATSA board member who serves as an At-Large Chair as well as the Ethics Chair. And does David Prescott, LCSW, LICSW really need an introduction? Did he not just win a lifetime achievement award at this year’s New York ATSA conference? Congratulations, David! You are a role model for the ATSA membership. 

I am sad to report that Ian McPhail, Ph.D. had to resign as the Associate Editor of the Research Corner. David Thornton, Ph.D. has agreed to assume this role. This issue includes his inaugural piece for the Research Corner in which he considers a recent publication by Aebi et al. (2022) regarding treatment outcomes for youth with histories of sexual offenses. I am also sad to see the resignation of another member of our staff, Robert Parham, M.A., who was one of our book reviewers. Becky Balmer, M.S., Review Editor for the Forum, will be looking for new book reviewers. If you are interested in becoming a book reviewer or volunteering for some other aspect of the Forum, please reach out to either myself or Becky. Luckily, we have two excellent book reviews by Tracy Tholin, Ms.Ed. and David Prescott, LCSW, LICSW.

I want to draw your attention to the Committee Updates. Did you know that the Juvenile Practice Committee changed their name? Amanda Pryor, MSW, LCSW, CSAYC and Arliss Kurtz, MSW, RSW tell us why. The Membership Committee takes highlights two special ATSA Fellows, Liam Marshall, Ph.D. and Joan Tabachnick, MBA. We also feature Gregg Belle, Ph.D. of Quincy, Massachusetts, U.S.A in our ATSA Member Highlight section. Gregg has some impressive experience, and he works near my favorite city in the U.S.

I hope you all enjoy your summer! I’ll be taking a break in Door County, Wisconsin. If you haven’t been there, it is a must see in the summer.



ATSA Presidentís Column

Tyffani Dent, PhD

The Courage and Importance In The “Why”

Within the work that we do, we are constantly asking “why”. We ask our clients about the harm that they have caused and why they did so. We ask the “why” of the measures we use to determine risk for reoffending (or not). We ask the “why” in the ways that rational approaches to re-entry and sentencing happens.

We ask “why’ in situations where, the very asking of the question, we run the risk of having others question our humanity or sensitivity to the needs of those who are harmed. Yet, we are asking “why” because we are trying to figure it out. We are trying to determine what needs to happen to prevent further sexual harm. We ask the “why” because we truly are trying to “Make Society Safer”.

In the recent Senate Confirmation Hearings for Judge Ketanji Brown Jackson, she was questioned about having the audacity to ask “why” when it came to sentencing guidelines for someone convicted of possessing child porn images. In her asking the “why” her goal was to make sense of what she stated was “to calculate the guideline but also look at various aspects of this offense and impose a sentence that is ‘sufficient but not greater than necessary’ to promote the purposes of punishment.”

There is courage required in asking the “why” when addressing the understandable emotion related to sexual harm. It is also necessary to do so. If we are truly seeking to engage in effective practices to treat those who have caused sexual harm, we must ask the “why” related to whether or not what we are doing works for the specific population with whom we are implementing that approach. We must ask the “why” is the research we are using to inform our work and our assessment measures are really useful and provide the information that we claim that they do. We must ask the “why” in “why” we are doing this work. Even in those moments when some of us have had to face reoffending happening, we also ask ourselves the sometimes (heart-wrenching) “why” as we evaluate our own work and whether we missed something.

As we continue to do this difficult and often misunderstood work, may we begin to recognize the importance and the audacity of never forgetting to embody “why”.

Tyffani Monford Dent, PsyD
ATSA President 

Alcohol, Consent Education, and Sexual Violence on College Campuses: Opportunities for Prevention?

This article provides an excellent review of the research related to sexual consent and sexual assault on college campuses.

by Kate Walsh, Ph.D.,
University of Wisconsin-Madison

Sexual assault, defined here as any non-consensual, unwanted sexual contact (e.g., groping, fondling) as well as attempted or completed oral, vaginal, or anal sexual penetration, is a significant problem on college campuses with 20-28% of women and 7-12% of men reporting a sexual assault during college (Fedina et al., 2018; Mellins et al., 2017). Rates are significantly higher among transgender, non-binary, and genderqueer students as well as those who identify as lesbian, gay or bisexual. Sexual assault is associated with risk for short and long-term physical and mental health problems (Dworkin et al., 2017) and is a significant economic burden, both to individuals and to society (Peterson et al., 2017). College students who experience sexual assault are more likely than their non-assaulted peers to drop out of college and those who remain in college report a negative impact of assault on their academic performance and career attainment following graduation (Mengo & Black, 2016; Potter et al., 2018). In the Centers for Disease Control’s systematic review of 140 primary prevention programs, only three were found to have any impact on sexual violence perpetration and none were at the collegiate level (DeGue et al., 2014). Identifying avenues for primary prevention of sexual violence among college students is of paramount importance.

Alcohol and Sexual Assault
A significant proportion of campus sexual assaults occur in the context of alcohol use (Abbey, 2002, Krebs et al., 2007; Lorenz & Ullman, 2016). For example, at the University of Wisconsin-Madison, the Association of American Universities data indicated that female survivors had been drinking alcohol in nearly 80% of penetrative sexual assaults and perpetrators had been drinking in 72% of assaults (Cantor et al., 2019). Unfortunately, state statutes addressing sexual assault are often inadequate for addressing campus sexual assault because half of the states do not include drug and alcohol intoxication as a mechanism of incapacitation (DeMatteo et al., 2015). Unsurprisingly, campus sexual assault survivors are also less likely to report their assaults to either campus authorities or law enforcement compared to same-age, non-student survivors of sexual assault (Sinozich & Langtson, 2014).

Meta-analyses also have indicated that approximately 60% of women who have had experiences that meet the behaviorally specific definitions of rape do not label their experiences as rape (Wilson & Miller, 2016). These findings have been explained using rape script theory, which asserts that most people think of “real rape” as an isolated assault by strangers where force and violence are the primary methods used (Kahn et al., 1994). However, the vast majority of sexual assaults are committed by people who are known to the survivor and many methods including incapacitation or verbal coercion or pressure may be used (Basile et al., 2011; Fedina et al., 2018; Mellins et al., 2017). When a person’s experiences does not match the narrow and less common script associated with “real rape,” they do not label their experiences as rape or sexual assault (Littleton et al., 2007). Assaults that involve alcohol or drug incapacitation are significantly less likely than those involving force to be acknowledged as rape or sexual assault, and survivors of these experiences may not be aware that they can report and/or receive services (Walsh et al., 2016). Indeed, at University of Wisconsin-Madison, among the 70% of penetrative assault survivors who did not access a resource, the most common reason for not accessing a resource was that they did not consider the assault “serious enough” and 53% of those who did not consider it “serious enough” indicated that alcohol or drugs had been involved (Cantor et al., 2019).

Sexual Consent and Sexual Assault

In addition to lacking acknowledgment of of substance-related incapacitation within many state statutes, the majority of state statutes also lack an explicit definition of sexual consent (DeMatteo et al., 2015). Failure to clearly define sexual consent not only contributes to the likelihood that survivors will not identify their non-consensual or unwanted sexual experience as an assault but also diminishes the likelihood that any reports made will result in charges and prosecution. Sexual consent has been defined for research purposes as a dynamic process that encompasses 1) a person’s internal feelings of willingness, which may include desire, wantedness, safety, etc; 2) their external communication of agreement or non-agreement, which may be active verbal statements, active nonverbal behaviors, passive verbalizations or behaviors, and lack of resistance; and 3) their interpretation of their partner’s behavior as willingness (see Muehlenhard et al., 2016 for review).

In a large representative sample of college students, 9% of students reported having sex with their partner when their partner may not have consented since starting college (Walsh et al., 2021). Numerous factors, including relationship to one’s partner (Jozkowski et al., 2014; Walsh et al, 2019), sexual precedence (i.e., whether the people involved had engaged in sexual behavior together before; Humphreys, 2007; Willis & Jozkowski, 2019), and whether substances were consumed by either partner (Jozkowski & Wiersma, 2015; Walsh et al., 2019) have all been shown to relate to complex patterns of internal consent feelings and external consent communication strategies. Qualitative studies of consent among college students highlight several challenges to clear and active communication about consent, including social norms around “drunk sex,” as well as cisgendered heterosexual “scripts” that ascribe the role of initiating sexual activity to men, the role of accepting or refusing sexual activity to women, and leave lesbian, gay, bisexual, trans and queer+ (LGBTQ+) students out of the conversation entirely (Hirsch et al., 2019). College students also describe reliance on indirect language (e.g., “do you want to go back to my room?”) to ask about consent and passive cues (e.g., going along with it) to indicate consent (Hirsch et al., 2019). The latter example is especially problematic because some studies have found that passive consent cues are unrelated to internal feelings of consent and thus passivity should not be used by partners to infer consent (Willis et al., 2019). To this end, some feminist scholars have highlighted the value of communicative sexuality, which moves away from using passive cues to infer consent and towards using a variety of active cues to infer consent (Beres, 2014; Pineau, 1996).

To address concerns about unclear communication about consent and create standards for consent communication, some states like California have enacted affirmative consent laws (DeMatteo et al., 2015). However, affirmative consent standards have been critiqued for not acknowledging that direct, nonverbal communication can be effective, as well as for failing to address verbal coercion tactics that result in unwanted encounters that are verbally agreed to (Pugh & Becker, 2018). Furthermore, students describe affirmative consent practices as awkward and uncomfortable (Shumlich & Fisher, 2020), suggesting that social norms may need to change to encourage people to communicate more directly.

One way that social norms around sexual consent may change is via education on these topics. Importantly, beginning conversations about sexual consent at the college level is inadequate as many people have already had sexual contact before college (Finer & Philbin, 2013) and a substantial number of people have already experienced sexual assault before college (e.g., Walsh et al., 2012). However, sexual consent discussions are missing from sex education at the K-12 level (Willis et al., 2019), leaving students woefully underprepared to engage in sexual relationships and communication about sexual relationships with others. In a recent national survey, young adults (age 18-24) endorsed pornography as the most common source they turn to when learning about how to have sex (Rothman et al., 2021). This is concerning because, with the exception of feminist pornography, which is typically expensive and difficult to find relative to free and widely available mainstream pornography, most pornography does not depict explicit discussions of or communication about consent. Although programs like bystander education (e.g., Gidycz et al., 2011) include elements of consent, they are often constrained to a single session of information that typically outlines definitions or policies. In one study that taught students about consent as a primary prevention strategy, those who received a longer consent education program with a discussion of policy and an interactive activity to reinforce learning retained more knowledge of consent compared to the control condition and those who received a shorter consent education program (Borges et al., 2008). However, knowledge gain may not be sufficient for behavior change. Students would likely benefit from ongoing developmentally appropriate education throughout their school years that allows opportunities for even greater immersion and engagement with the topic (e.g., role-playing difficult conversations where people are balancing competing concerns and pressures).

Developing comprehensive and interactive programming to teach students about consent and healthy relationships is unlikely to curb all instances of sexual violence. However, programming that provides students with information about how to engage in sexual relationships; how to clarify encounters and situations within an encounter that are ambiguous; opportunities to explore their personal sexual desires, boundaries, and goals; and opportunities to practice having awkward conversations and try out responses to different scenarios could be impactful and empowering in helping students develop the skills to navigate sexual consent with intentionality. Programming of this kind may result in fewer ambiguous encounters characterized by a lack of agency and/or miscommunication and could help students develop skills that can be generalized to situations in which they are negotiating consent under the influence of alcohol.

This author did not have any financial interests to declare.


Abbey, A. (2002). Alcohol-related sexual assault: a common problem among college students. Journal of Studies on Alcohol, supplement, (14), 118-128.

Basile, K. C., Black, M. C., Breiding, M. J., Chen, J., Merrick, M. T., Smith, S. G., & Walters, M. L. (2011). National intimate partner and sexual violence survey: 2010 summary report.

Beres, M. A. (2014). Rethinking the concept of consent for anti-sexual violence activism and education. Feminism & Psychology, 24(3), 373-389.

Borges, A. M., Banyard, V. L., & Moynihan, M. M. (2008). Clarifying consent: Primary prevention of sexual assault on a college campus. Journal of Prevention & Intervention in the Community, 36(1-2), 75-88.

Cantor, D., Fisher, B., Chibnall, S., Harps, S., Townsend, R., Thomas, G., & Madden, K. (2019). Report on the AAU campus climate survey on sexual assault and misconduct. The Association of American Universities, Westat, Rockville, Maryland.

DeGue, S., Valle, L. A., Holt, M. K., Massetti, G. M., Matjasko, J. L., & Tharp, A. T. (2014). A systematic review of primary prevention strategies for sexual violence perpetration. Aggression and violent behavior, 19(4), 346-362.

DeMatteo, D., Galloway, M., Arnold, S., & Patel, U. (2015). Sexual assault on college campuses: A 50-state survey of criminal sexual assault statutes and their relevance to campus sexual assault. Psychology, Public Policy, and Law, 21(3), 227.

Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E. (2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical psychology review, 56, 65-81.

Fedina, L., Holmes, J. L., & Backes, B. L. (2018). Campus sexual assault: A systematic review of prevalence research from 2000 to 2015. Trauma, violence, & abuse, 19(1), 76-93.

Finer, L. B., & Philbin, J. M. (2013). Sexual initiation, contraceptive use, and pregnancy among young adolescents. Pediatrics, 131, 886–891.

Gidycz, C. A., Orchowski, L. M., & Berkowitz, A. D. (2011). Preventing sexual aggression among college men: An evaluation of a social norms and bystander intervention program. Violence against women, 17(6), 720-742.

Hirsch, J. S., Khan, S. R. Wamboldt, A., & Mellins, C. A. (2019). Social dimensions of sexual consent among cisgender heterosexual college students: Insights from ethnographic research. Journal of Adolescent Health, 64(1), 26-35.

Humphreys, T. (2007). Perceptions of sexual consent: The impact of relationship history and gender. Journal of Sex Research, 44(4), 307-315.

Jozkowski, K. N., Sanders, S., Peterson, Z. D., Dennis, B., & Reece, M. (2014). Consenting to sexual activity: The development and psychometric assessment of dual measures of consent. Archives of sexual behavior, 43(3), 437-450.

Jozkowski, K. N., & Wiersma, J. D. (2015). Does drinking alcohol prior to sexual activity influence college students’ consent?. International Journal of Sexual Health, 27(2), 156-174.

Kahn, A. S., Mathie, V. A., & Torgler, C. (1994). Rape scripts and rape acknowledgment. Psychology of Women Quarterly, 18(1), 53-66.

Krebs, C., Lindquist, C., Warner, T., Fisher, B., & Martin, S. (2007). The campus sexual assault (CSA) study.

Littleton, H. L., Rhatigan, D. L., & Axsom, D. (2007). Unacknowledged rape: How much do we know about the hidden rape victim?. Journal of Aggression, Maltreatment & Trauma, 14(4), 57-74.

Lorenz, K., & Ullman, S. E. (2016). Alcohol and sexual assault victimization: Research findings and future directions. Aggression and Violent Behavior, 31, 82-94.

Mellins, C. A., Walsh, K., Sarvet, A. L., Wall, M., Gilbert, L., Santelli, J. S., Reardon, L. & Hirsch, J. S. (2017). Sexual assault incidents among college undergraduates: Prevalence and factors associated with risk. PLoS one, 12(11), e0186471.

Mengo, C., & Black, B. M. (2016). Violence victimization on a college campus: Impact on GPA and school dropout. Journal of College Student Retention: Research, Theory & Practice, 18(2), 234-248.

Muehlenhard, C. L., Peterson, Z. D., Humphreys, T. P., & Jozkowski, K. N. (2017). Evaluating the one-in-five statistic: Women’s risk of sexual assault while in college. The Journal of Sex Research, 54(4-5), 549-576.

Peterson, C., DeGue, S., Florence, C., & Lokey, C. N. (2017). Lifetime economic burden of rape among US adults. American journal of Preventive Medicine, 52(6), 691-701.

Pineau, L. (1996) ‘A Response to my Critics’, in L. Francis (ed.) Date Rape: Feminism, Philosophy and the Law. University Park, Pennsylvania: The Pennsylvania University Press.

Potter, S., Howard, R., Murphy, S., & Moynihan, M. M. (2018). Long-term impacts of college sexual assaults on women survivors' educational and career attainments. Journal of American College Health, 66(6), 496-507.

Pugh, B., & Becker, P. (2018). Exploring definitions and prevalence of verbal sexual coercion and its relationship to consent to unwanted sex: Implications for affirmative consent standards on college campuses. Behavioral Sciences, 8(8), 69.

Rothman, E. F., Beckmeyer, J. J., Herbenick, D., Fu, T. C., Dodge, B., & Fortenberry, J. D. (2021). The prevalence of using pornography for information about how to have sex: Findings from a nationally representative survey of US adolescents and young adults. Archives of Sexual Behavior, 50(2), 629-646.

Shumlich, E. J., & Fisher, W. A. (2020). An exploration of factors that influence enactment of affirmative consent behaviors. The Journal of Sex Research, 57(9), 1108-1121.

Sinozich, S., & Langton, L. (2014). Rape and sexual assault victimization among college-age females, 1995-2013. Washington, DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Walsh, K., Danielson, C. K., McCauley, J. L., Saunders, B. E., Kilpatrick, D. G., & Resnick, H. S. (2012). National prevalence of posttraumatic stress disorder among sexually revictimized adolescent, college, and adult household-residing women. Archives of General Psychiatry, 69(9), 935-942.

Walsh, K., Honickman, S., Valdespino-Hayden, Z., & Lowe, S. R. (2019). Dual measures of sexual consent: A confirmatory factor analysis of the Internal Consent Scale and External Consent Scale. The Journal of Sex Research, 56(6), 802-810.

Walsh, K., Sarvet, A. L., Wall, M., Gilbert, L., Santelli, J., Khan, S., Reardon, L., Hirsch, J., & Mellins, C. A. (2021). Prevalence and correlates of sexual assault perpetration and ambiguous consent in a representative sample of college students. Journal of Interpersonal Violence, 36(13-14), NP7005-NP7026.

Walsh, K., Zinzow, H. M., Badour, C. L., Ruggiero, K. J., Kilpatrick, D. G., & Resnick, H. S. (2016). Understanding disparities in service seeking following forcible versus drug-or alcohol-facilitated/incapacitated rape. Journal of interpersonal violence, 31(14), 2475-2491.

Willis, M., & Jozkowski, K. N. (2019). Sexual precedent’s effect on sexual consent communication. Archives of Sexual Behavior, 48(6), 1723-1734.

Willis, M., Blunt-Vinti, H. D., & Jozkowski, K. N. (2019a). Associations between internal and external sexual consent in a diverse national sample of women. Personality and Individual Differences, 149, 37-45.

Willis, M., Jozkowski, K. N., & Read, J. (2019b). Sexual consent in K–12 sex education: An analysis of current health education standards in the United States. Sex Education, 19(2), 226-236.

Wilson, L. C., & Miller, K. E. (2016). Meta-analysis of the prevalence of unacknowledged rape. Trauma, Violence, & Abuse, 17(2), 149-159.


Bestiality and its Relevance in Psychosexual Evaluations
This article provides an excellent review of the research on bestiality as well as issues clinicians and evaluators should consider during assessments.

by Brian Holoyda, MD, MPH, MBA
Martinez Detention Facility

Bestiality, or sexual activity between humans and nonhuman animals, has been a source of both fascination and revulsion since earliest recorded human history. That ancient Greek myths often depict sexual acts between humans and other animals demonstrates that bestiality either occurred or was in the popular imagination at the time. In 2017, a movie depicting the relationship between a woman and a fish-like anthropomorphic creature, The Shape of Water, won the Academy Award for Best Picture. Societies have dealt with bestiality through legal codes across history as demonstrated by some of the earliest laws ever recorded. For example, the Hittites are thought to have written their laws in cuneiform on clay tablets between the years 1650 B.C. and 1500 B.C., including four laws that directly address bestiality (Roth et al., 1995). Despite humanity’s long-standing interest in and legislation of bestiality, it is perhaps one of the least understand aspects of human sexuality. Studies on individuals who have sex with animals are largely siloed to different samples that are not representative of the general population. This puts lawmakers and forensic evaluators in a difficult place, creating laws and generating risk assessments with little research support. This article serves as an introduction to bestiality with a focus on the growing recent body of literature examining its relationship to other problematic sexual behaviors.


The word bestiality refers to sexual acts between human and nonhuman animals. In the field of veterinary medicine the term animal sexual abuse is the “preferred and encompassing term for all sexual contact between people and animals” (Stern & Smith-Blackmore, 2016, p. 1058), as it highlights harms that may occur to the animal from sex with humans. Zoophilia is a paraphilia in which the object of intense and persistent sexual interest is an animal or sexual acts involving animals. With the transition from DSM-IV-TR to DSM-5, a paraphilia is a paraphilic disorder when the individual experiences distress or impairment from the paraphilia or when its “satisfaction has entailed personal harm, or risk of harm, to others” (APA, 2013, pp. 685-686). There is no specified zoophilic disorder diagnosis in DSM-5, however the text indicates that it may be diagnosed under the category of other specified paraphilic disorder (OSPD). To meet criteria for OSPD (zoophilia), then, an individual with zoophilia would have to act on the zoophilic interest or experience distress or impairment related to the sexual interest. There is a selection of terms that some individuals with zoophilic interest and others who engage in sex with animals have adopted to describe themselves. A bestialist engages in sexual contact with animals, whereas zoophiles, zoos, zoosexuals, or zooerasts report having intimate relationships with animals in which sexual activity may be involved (Holoyda et al., 2018).
Bestiality Basics

Remarkably little is known regarding basic scientific issues related to bestiality, for example who engages in sex with animals, what animals are utilized for sex acts, and why people do it. One of the most extensive surveys of sex with animals comes from Alfred Kinsey and colleagues (1948), who reported that 8% of males had sexual contact with animals across the lifespan. The prevalence of such a history increased to 40-50% when restricting the sample to farm-raised men. In some rural Western communities, 65% of men reported having had sex with animals, including some who did so multiple times each week over many years. Among women, Kinsey and colleagues (1953) identified lower rates of bestiality, noting that 1.5% of their sample had sexual contact with an animal prior to adolescence and 3.6% after adolescence. Since Kinsey’s studies, there have been few large-scale epidemiologic surveys on bestiality. One survey of the general population in U.S. cities in the 1970’s found that 5% of men and 2% of women reported having sexual contact with an animal (Hunt, 1974). Other studies have utilized samples that are not representative of the general population. For example, in two studies of male prisoners in the southern United States, Hensley and colleagues (2006, 2010) found that 6% and 20% reported previously having sex with animals. In a study of forensically committed male sexual offenders at a state hospital in California, Holoyda (2017) found that 3.6% (n = 3) reported a history of bestiality, of whom two were diagnosed with zoophilia. Out of 1248 individuals committed as sexually violent predators in Virginia, Holoyda and colleagues (2020) discovered that 2.6% reported a history of bestiality.

Kinsey and colleagues (1948) found that men most often reported having sex with calves, burros, and sheep, though dogs, cats, chickens, ducks, and geese were also mentioned. Of possible sex acts, penile penetration of the animal’s vagina was most common, followed by masturbating the animal, fellatio of the human, and penile penetration of the animal’s anus. Among women (1953), however, three-quarters reported having sex with dogs and most others reported cats. Most acts involved general body contact, touching an animal’s genitals, or masturbating the animal. Less commonly, the animal performed cunnilingus on the woman. In her study of self-identified zoophiles, Hani Miletski (2002) found that 63% of 82 men and 100% of 11 women first experienced bestiality with a dog, while 14 men first did so with a horse. Over 30% of the men in her sample reported primary sexual acts of masturbating a male animal, penile-vaginal intercourse with a female animal, fellating a male animal, masturbating a female animal, being anally penetrated by a male animal, or performing cunnilingus on a female animal. Of her female subjects, over 30% reported primary sexual acts of masturbating a male animal, receiving cunnilingus from a male animal, receiving penile-vaginal penetration from a male animal, performing fellatio on a male animal, and receiving cunnilingus from a female animal. Other studies of self-identified zoophiles have identified similar animals and sexual acts of preference (Beetz, 2002; Williams and Weinberg, 2003).

The motivations for which individuals engage in sex with animals are poorly understood. Miletski’s (2002) self-identified zoophile subjects most often reported motivations of being sexually attracted to the animals, wanting to express love or affection, the animal wanting it, or the animal being accepting and easy to please. Williams and Weinberg (2003) identified similar reasons that zoophiles engaged in sex with animals. Other researchers have described prisoners engaging in sex with animals as an act of animal cruelty alongside other physically harmful acts like hitting, kicking, shooting, or drowning animals (Henderson et al., 2011; Hensley et al., 2006; Hensley et al., 2010). It is not clear from these studies if all participants were intentionally inflicting pain on the animals, however the authors suggested that bestiality may represent one form of violence against animals. As Holoyda described in 2016, other potential motivations for bestiality include culturally sanctioned practices, financial gain, psychosis, intoxication, cognitive or impairment, or sensory preferences associated with autism spectrum disorder.

Bestiality and Forensically Relevant Research

Most studies assessing the psychopathology of individuals with a history of bestiality have focused on samples with comorbid psychiatric problems or those facing legal sanctions. One consistent finding of this small body of literature is that a history of bestiality is likely related to other paraphilic interests and/or disorders. In Abel and colleagues’ 1988 study of over 500 men voluntarily seeking treatment for problematic sexual behaviors, 14 reported a history of bestiality. The average number of comorbid paraphilias in these men was 4.8, the third highest after those reporting a history of obscene phone calling and public masturbation. No individual reporting a history of bestiality had a single comorbid paraphilia. In their study of Virginian Sexually Violent Predators (SVPs), Holoyda and colleagues (2020) found that those with a history of bestiality were more likely to report having sexually abused a child (63.6%) and to have engaged in necrophilic acts (6.1%) than SVPs without a history of bestiality. The former finding supports Abel’s 2008 report that bestiality, when compared to other paraphilic and problematic sexual behaviors, is the greatest predictor for the commission of child sexual abuse. This body of evidence reinforces the concept of paraphilic crossover, defined as the often broad-ranging problematic sexual interests and behaviors seen in those with paraphilic disorders, including those with a history of zoophilia or bestiality. Though some case reports have identified a relationship between certain psychopathological states and acts of bestiality, there is no clear relationship between mood, psychotic, or other mental illnesses and sex with animals.

There have been numerous studies examining bestiality as an act of animal cruelty, specifically as a predictor of future interpersonal violence, a relationship commonly referred to as “the Link.” In a study of 261 prisoners in the southern United States, Hensley and colleagues (2006) found that about 6% reported engaging in bestiality during childhood and adolescence. Those reporting such a history were significantly more likely to have committed an interpersonal crime and to have a history of more interpersonal crimes than those without such a history. In a follow-up survey of 180 prisoners, Hensley and colleagues (2010) found that about 13% reported a history of childhood bestiality and they confirmed their prior findings. Using the same dataset, Henderson and colleagues (2011) compared bestiality to a variety of other physical forms of animal abuse and found that only bestiality predicted recurrent interpersonal violence in adulthood. Based on this limited body of evidence, the researchers proposed that a history of childhood bestiality may be a risk factor for adult interpersonal violence.

As already described, Holoyda and colleagues (2018) and Abel (2008) found that bestiality may be a risk factor for the commission of child sexual abuse in SVPs and men assessed for problematic sexual behaviors, respectively. A recent study on individuals arrested for animal cruelty supports this hypothesis. Levitt and colleagues (2016) studied 150 adult animal cruelty offenders, 35 of whom were arrested for bestiality. About one-third (n = 12) of these individuals also had a history of sexually assaulting a human and more than half of their victims were under the age of 18. Similarly, Edwards (2019) published a review of 472 arrests for bestiality in the United States between 1975 and 2015. Over half of the 456 adult offenders had a prior criminal history, of whom one-third had committed a sexual offense. In 144 arrests (31.6%), the offender directly sexually victimized 213 children and 28 adults. Fifty arrests involved bestiality plus sex with a child or non-consenting adult and thirty involved the coercion of a child or adult to have sex with an animal.

Most recently, researchers have been exploring the relationship between bestiality and the possession of child sexual exploitation materials (CSEM). Seto and Eke (2015) found that 15% of adult male CSEM offenders collected bestiality material within five years of release from custody. Steel and colleagues (2021) compared pornography viewing habits between 254 members of the public and 78 adults convicted of CSEM-related offenses. Forty-four percent of the offender group reported viewing adult pornography involving bestiality and 18% reported viewing CSEM involving bestiality. Three percent of the public sample reported viewing any pornography involving bestiality. The offender-to-public ratio of viewing bestiality material (15.82) was greater than that for any other type of pornography, including rape, anal sex, teen sex, hentai, and others. In Edwards’ (2019) study, most bestiality-related arrests involving children related to the production of CSEM or coercion of the child to engage in sexual activity with an animal. These studies suggest that individuals with a history of CSEM offenses may be more likely to view bestiality material.


Data on bestiality is limited and represents an area for further study, including to further delineate the relationship between bestiality and other paraphilic disorders, child sexual abuse, CSEM offending, and other problematic sexual behaviors. With more data, evaluators will be better suited to incorporate a history of bestiality into a sexual violence risk formulation. Current research seems to support the hypothesis that bestiality is associated with various other problematic behaviors, including sexual assault of adults, child sexual abuse, and the viewing and/or possession of CSEM. While elucidating the violence risk implications of bestiality is important, it is also essential to better understand basic issues related to the behavior, for example the incidence of bestiality today and the motivations for which individuals engage in sex with animals. Without this important “base rate” information, evaluators will struggle to place evaluees’ acts of bestiality in context and to formulate appropriate, unbiased conclusions regarding individuals’ behavior and future risk.

This author has no financial disclosures to declare.


Abel, G. G. (2008). What can 44,000 men and 12,000 boys with sexual behavior problems teach us about preventing sexual abuse? Paper presented at the Annual Training Conference of the California Coalition on Sexual Offending 11th Annual Training Conference, San Francisco, California, USA.

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bull Am Acad Psychiatry Law, 16(2), 153-168.

American Psychiatric Association. (2013). The diagnostic and statistical manual of mental disorders, 5th edition. Washington, DC: American Psychiatric Publishing Inc.

Beetz, A. (2002). Love, violence, and sexuality in relationships between humans and animals. Aachen, Germany.

Dale, J. M. (Producer), & Del Toro, G. (Director). (2017). The shape of water. United States: TSG Entertainment.

Edwards, M. J. (2019). Arrest and Prosecution of Animal Sex Abuse (Bestiality) Offenders in the United States, 1975-2015. J Am Acad Psychiatry Law, 47(3), 335-346. doi:10.29158/JAAPL.003836-19

Henderson, B. B., Hensley, C., & Tallichet, S. E. (2011). Childhood animal cruelty methods and their link to adult interpersonal violence. J Interpers Violence, 26(11), 2211-2227. doi:10.1177/0886260510383038

Hensley, C., Tallichet, S. E., & Dutkiewicz, E. L. (2010). Childhood bestiality: a potential precursor to adult interpersonal violence. J Interpers Violence, 25(3), 557-567. doi:10.1177/0886260509360988

Hensley, C., Tallichet, S. E., & Singer, S. D. (2006). Exploring the possible link between childhood and adolescent bestiality and interpersonal violence. J Interpers Violence, 21(7), 910-923. doi:10.1177/0886260506288937

Holoyda, B. (2017). Bestiality in Forensically Committed Sexual Offenders: A Case Series. J Forensic Sci, 62(2), 541-544. doi:10.1111/1556-4029.13255

Holoyda, B., Gosal, R., & Welch, K. M. (2020). Bestiality Among Sexually Violent Predators. J Am Acad Psychiatry Law, 48(3), 358-364. doi:10.29158/JAAPL.003941-20

Holoyda, B., Sorrentino, R., Friedman, S. H., & Allgire, J. (2018). Bestiality: An introduction for mental health professionals. Behav Sci Law, 36, 687-697.

Holoyda, B., & Newman, W. J. (2016). Childhood animal cruelty, bestiality, and the link to adult interpersonal violence. Int J Law Psychiatry, 47, 129-135.

Hunt, M. M. (1974). Sexual behavior in the 1970s (1st ed.). Chicago: Playboy Press.

Institute for Sex Research., & Kinsey, A. C. (1953). Sexual behavior in the human female. Philadelphia,: Saunders.

Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia,: W. B. Saunders Co.

Levitt, L., Hoffer, T.A., Loper, A.B. (2016). Criminal histories of a subsample of animal cruelty offenders. Aggression and Violent Behavior, 30, 48-58.

Miletski, H. (2002). Understanding Bestiality and Zoophilia. Bethesda, Maryland: East-West Publishing.

Roth, M. T., Hoffner, H. A., & Michalowski, P. (1995). Law collections from Mesopotamia and Asia Minor. Altanta, Ga.: Scholars Press.

Seto, M. C., & Eke, A. W. (2015). Predicting recidivism among adult male child pornography offenders: Development of the Child Pornography Offender Risk Tool (CPORT). Law Hum Behav, 39(4), 416-429. doi:10.1037/lhb0000128

Steel, C. M. S., Newman, E., O'Rourke, S., & Quayle, E. (2021). Collecting and viewing behaviors of child sexual exploitation material offenders. Child Abuse Negl, 118, 105133. doi:10.1016/j.chiabu.2021.105133

Stern, A. W., & Smith-Blackmore, M. (2016). Veterinary Forensic Pathology of Animal Sexual Abuse. Vet Pathol, 53(5), 1057-1066. doi:10.1177/0300985816643574

Williams, C. J., & Weinberg, M. S. (2003). Zoophilia in men: a study of sexual interest in animals. Arch Sex Behav, 32(6), 523-535. doi:10.1023/a:1026085410617


Treating Anxious Teens in an Anxious World
In this article, Janet describes the importance of helping anxious teens learn compassion, self-care, and mindfulness techniques.

Janet DiGiorgio-Miller, Ph.D.

Anxiety is often found in adolescence, as it is a time of stress developmentally. They are questioning themselves in every aspect of their life and comparing themselves even more due to social media. Many teenagers who experience anxiety are unable to effectively manage their stress.

Child and adolescent anxiety have increased during recent global events, as it has for most people. This is especially true during these “extraordinary and uncertain times,” where it would be “normal” for teens to be worried (Parsons, 2020).  The resolution of our current health crisis will not necessarily alleviate underlying circumstances that contribute to pediatric anxiety. Instead, clinicians need to continue  to help clients to continue to effectively manage their anxiety.

Anxiety has been the most prevalent mental health disorder experienced by children and adolescents in the United States for decades. In 1999, the U.S. Surgeon General described the prevalence of pediatric anxiety disorders in the U.S. as higher than that of all other mental disorders of childhood and adolescence, experienced by 13 percent of children and teenagers. In addition, as described by the Surgeon General, the relationship between childhood mental disorders and stressful life events is well-established, in which adverse developmental and environmental factors are part of the context within which mental or behavioral health difficulties occur. “Even more than for adults … children must be seen in the context of their social environments” (Satcher, 2000). It is no surprise, then, that anxiety in children and teens has increased during the pandemic (Bera et al., 2022).

One important aspect is that adolescents have been impacted by the pandemic in ways most of us have not, academically. Not only do they worry if they can compete with other potential college/job applicants due to virtual learning but they are closely watching the economy and the impact it will have on them. Not to mention, no social activity to mark significant life events. The adolescent brain still has about ten more years to develop so each event is significant.

However, some anxious children and teens actually feel more comfortable during the isolation, especially if they experience social anxiety. Required restrictions partly eliminate the stress that social interactions and expectations may otherwise bring. At the same time, these young people also have more time to imagine the worst for themselves, their families, and the world around them. On top of that, not knowing what is ahead itself may increase anxiety. Even social media has become a stressful environment due to racial and political tensions.

Clinicians need to address the source of anxiety for young people, but we also need to address and treat the anxiety itself to help clients discover ways to better manage it. Mindfulness and meditation when used with traditional CBT are more efficient ways to work with anxious teens. CBT can mitigate fears and mindfulness and compassion can assist in having the client feel supported in changing thoughts and emotions. Meditation is supported by research as helpful in managing anxiety (Jennings, & Jennings, 2013; Mostafazadeh et al., 2019). Nevertheless, it is difficult for many clients to embrace these techniques or ideas because they may have difficulty sustaining focus or finding time, or remembering to meditate, or perhaps even believing that meditation is effective or has a place in their life. These are obstacles to overcome in helping young people learn that they have the capacity to manage their anxiety, in part by breathing, attending to the moment, and grounding themselves.

When we take a pause, breathing in a meditative fashion (for instance, counting to four with each breath in and out, several times), a more mindful state of mind develops in which we can consider and adopt a more balanced perspective. Mindfulness can create a comfort zone in which our clients can use their own breath or surroundings to feel grounded in an unpredictable world. Mindfulness is empowering when teens learn that if they can manage their breath, they can slow the beat of their heart, emotionally relax, better handle stress, and make better decisions.

Compassion for self and others enhances the body’s preparedness for stress. (Bluth & Eisenlohr, 2017; Lathren et al., 2019). Mindfulness allows young people to become more aware of their judgments and adopt a kinder view of themselves and others. This takes practice, of course, as the self-perceptions of many at-risk adolescents often lead to harsh self-evaluation and evaluation of others. One simple technique teaches young people how to take a mindful pause to notice critical self-talk—but just notice, not judge. They are thus able to become more aware of these automatic negative thoughts and can use a mindful space to challenge them. Similarly, the “lovingkindness” meditation—which has young people wishing well to themselves, someone they love, someone they find difficult, and the world around them—usually involves four simple phrases related to being safe, being healthy, being calm, and living life with ease.

Anxiety often leads to a problematic form of self-focus, in which anxious young people focus on holding their anxieties at bay, rather than on managing it and being present and part of the world around them. It is important to help them learn how to better respond to others, but it is also important to help them become more mindful in their interactions with others. Mindfully listening to help us become attuned and create a safer emotional and social environment for the teen. For many at-risk teens, this process is not natural; it takes time and practice for them to develop the skills to take pause and be present. It is the practitioners’ job to be mindfully patient and support the teen through this process of learning and practice. As the world events impact us as well as our clients, it is important that we take care of ourselves mentally, emotionally, and physically. Self-care can include the very techniques listed above.

As with other mindfulness techniques, these methods take practice and regular use. There are easily accessible resources. Dr. Kristen Neff’s website, for instance, describes and teaches self-compassion and other techniques


This author disclosed that this article was previously published in The Circle and used with permission: circle magazine link


Bera, L., Souchon, M., Ladsous, A., Colin, V., & Lopez-Castroman, J. (2022). Emotional and behavioral impact of the COVID-19 epidemic in adolescents. Current Psychiatry Reports, 1-10.

Bluth, K., & Eisenlohr-Moul, T. A. (2017). Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes. Journal of adolescence, 57, 108–118.

Jennings, S. J., & Jennings, J. L. (2013). Peer-directed, brief mindfulness training with adolescents: A pilot study. International Journal of Behavioral Consultation and Therapy, 8(2), 23.

Mostafazadeh, P., Ebadi, Z., Mousavi, S., & Nouroozi, N. (2019). Effectiveness of School-Based Mindfulness Training as a Program to Prevent Stress, Anxiety, and Depression in High School Students. Health Education and Health Promotion, 7(3), 1-6.

Parsons, J. (2020). COVID-19, children and anxiety in 2020. Australian Journal of General Practice, 49, Suppl 27.

Satcher, D. S. (2000, Jan-Feb). Executive summary: A report of the Surgeon General on mental health. Public Health Report, 115(1), 89–101.

U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon-General.

Lathren, C., Bluth, K., & Park, J. (2019). Adolescent self-compassion moderates the relationship between perceived stress and internalizing symptoms. Personality and Individual Differences, 143, 36–41.

Examining the Dark Sides of Psychedelic Therapy
In this article, the authors explore the unfortunate presence of sexual abuse within some experiences of psychedelic therapy.

by Natalie Villeneuve, MSW, RSW, and David Prescott, LICSW


Across the globe, there is an ever-growing sense of hope and excitement around the promise of psychedelic therapies to heal, going so far as regarding them as a potential miracle cure (George et al., 2020; Mac, 2021). Tracing back thousands of years, plant-based psychedelics have long been considered a powerful healing agent by Indigenous2 communities worldwide (Nomoto, 2020). In more recent times, psychedelic medicines have been popularized within Western culture, and they are gaining traction as a revolutionary approach to alleviating trauma, in addition to treating a number of other mental health conditions.

Many prominent figures are invested in legitimizing psychedelic science, including celebrities such as Tim Ferriss, who reported that he “put aside most of his other projects to advance psychedelic medicine” (Carey, 2019, para. 3), and Elon Musk, currently the richest man in the world, who shared in a tweet stating that he has “talked to many more people who were helped by psychedelics & ketamine than SSRIs & amphetamines” (Forbes, 2022; Musk, 2022). World-renowned trauma experts such as Dr. Gabor Maté and Bessel van der Kolk promote the use of psychedelics in psychotherapy, and journalist, while author Michael Pollan brought the potential of these drugs to the forefront in his best-selling book How to Change Your Mind (Simon, 2018).

Yet, as the conversations around psychedelic therapies grow louder, there are voices that are continuously being silenced as they attempt to speak out against the harm they have experienced with the re-awakened interest in psychedelic drugs. Numerous individuals are coming forward with serious concerns about being sexually abused during their guided psychedelic experiences. In response, they are being dismissed, blamed, gaslighted, and further traumatized by the individuals and institutions who fear that this will undermine the psychedelic movement.

Power Trip

An investigative podcast series, Cover Story: Power Trip, delves into these stories of abuse and speaks with many individuals who have been harmed within psychedelic therapy, not only by therapists, but also by the system that is failing to respond, much less account for their actions or assist those who have been abused. Even within highly monitored clinical trials, a participant reports that she was repeatedly sexually assaulted by her therapist, Richard Yensen (who was later found to be an unregulated therapist), even while he was working alongside his wife, psychiatrist Dr. Donna Dryer, and even though these sessions were being filmed (Lindsay, 2021). These trials were sponsored by the Multidisciplinary Association for Psychedelic Research (MAPS), a leading organization in the research of psychedelic medicines. Despite the major concerns with the behaviour of these therapists that occurred under their guidance – and even further the significant ethical concerns within the research itself – MAPS’s responses continue to be appalling. The organization has not made any meaningful effort to prevent further harm.

The podcast recounts how, when host Lily Kay Ross, Ph.D., attempted to speak up about her own experiences of abuse within guided psychedelic ceremonies, she (like many others) got the message, directly and indirectly, that if she continues to bring forward these concerns she would be “single-handedly re-instigating the war on drugs and undoing decades of research” (Ross, 2021). This was despite the recognition that Lily was only one of “hundreds of women” who had experienced sexual harm through psychedelic therapies (Ross, 2021).


Largely ignoring the cries for help, research into psychedelics is rapidly accelerating, and discourse around the medicines’ ability to heal trauma is overshadowing the fact that not only are these therapies oftentimes failing to “cure” the participants, but they are also actively traumatizing some of those who have undertaken this treatment. With such strong enthusiasm about how powerfully healing these substances can be, proponents are proceeding with apparent tunnel vision in the advancement of psychedelic therapy, while failing to acknowledge the significant number of participants who experience further trauma as a result of the concerning and outright abusive actions that some therapists commit within these practices.

It is important to note that this is not the first time that psychedelics promised to revolutionize psychiatry. Psychedelics were popularized in the 1950s as a promising way to treat trauma, addiction, anxiety, and depression, but this research was shut down after psychedelic medicines (including MDMA, DMT/Ayahuasca, Psilocybin, LSD, and others) became associated with the 1960s counterculture. The stigma that these substances carry is, in large part, a result of the war on drugs that still holds sway today.

However, the mindset is beginning to shift as people worldwide hear about how impactful these substances can be on mental health. Globally, individuals are becoming more concerned with their mental health and finding themselves with few resources while faced with a global pandemic, the threats from climate change, war, and social unrest. It is understandable why many people are invested in the possibility of a miracle drug, a “one-stop-shop” to cure all your ills.  

Before the 1950s hype around psychedelics, plant-based psychedelic medicines had been regarded as a powerful healing agent for thousands of years across non-Western cultures (Sessa, 2006). Yet, in 1955, R. Gordon Wasson, the vice president of J.P. Morgan, believed himself to be one of the “first white men in recorded history to eat the divine mushrooms” (Wasson, 1957, para. 2) following a psychedelic journey in Mexico guided by Mazatec curandera Maria Sabina, a traditional healer or “medicine woman” (Kabil, 2017; Vargas, 2017).

Subsequent to his journey with Sabina, Wasson published an article outing Sabina to the Western world despite his promise not to, and the consequences devastated Sabina who was ostracized from her community, had her house burned down, and ultimately died in extreme poverty (Gerber et al., 2021; Sharma, 2021; Vargas, 2017). When Dr. Timothy Leary read the article, he traveled to Cuernavaca, Mexico to partake in a mushroom ritual that transformed his perspective of psychology. He returned to Harvard passionate about bringing psilocybin into therapy in the Western world, contributing in large part to the colonization of the psychedelic experience. Leary went on to advocate for the use of psychedelics within the general public, and his research on psychedelics became increasingly “undisciplined and unstructured” (Encyclopaedia Britannica, 2022, para. 4). One of the criticisms of Leary’s approach is that he tended to overemphasize the benefits of psychedelic therapy without discussing the potential consequences (Kabil, 2017).

It is difficult to overlook how the introduction of psychedelics to the Western world is steeped in colonialism, and the demise of research in the 1960s can be largely attributed to the overzealousness, and as a result, recklessness, within the field of psychedelics. Within the current so-called psychedelic renaissance (a term which seems to be gaining currency among those advancing psychedelics), many who understand the history of this movement will argue the importance of not repeating “the mistakes of the past” (George et al., 2020, p. 5). Yet some within this movement are driving forward, causing direct harm and/or neglecting to address it.

If we are truly committed to bringing psychedelic therapy to the mainstream and ensuring that it can be the powerful agent of healing that Indigenous cultures have known it to be for centuries, then there are many considerations that need to be talked about before we proceed any further. First, we must honour the Indigenous roots of psychedelic healing and ask ourselves, “Do we want to perpetuate the erasure of Indigenous peoples and knowledge systems or are we ready to embrace them as equal partners?” (Fotiou, 2020, p. 20). Additionally, we need to acknowledge that people are being seriously hurt within guided psychedelic experiences.  Consequently, we must develop and enforce the most stringent codes of ethics and professionalism to prevent these abuses, while accepting accountability when harm does occur and always seeking to do better. From a scientific perspective, we must become attentive when people report adverse symptoms following treatment, and view this as an opportunity for learning and growth within the field. If we are claiming that psychedelics can heal trauma, then the practitioners guiding these experiences must be highly trained, regulated, and screened as experienced trauma therapists. When participants courageously step forward with claims of feeling harmed by their psychedelic guide, then we must create space for conversations of healing that focus on the participant and that require full accountability and genuine interest on the part of practitioners in how to do better. When practitioners choose to regard themselves as all-knowing and incapable of doing harm, then we must relieve them of their right to offer healing services when their actions are directly counteracting the definition of healing.


Before delving any deeper, it is important to contextualize some of the abuse that is occurring within psychedelic practices. This is not the case of just a single account of abuse; rather, there are multiple allegations arising from many individuals against different therapists, some of whom have been accused of various accounts of abuse (Hall, 2021b; Tillett Wright, 2021, 2022). This abuse includes ethical and boundary violations, such as encouraging emotional dependency from client to therapist, as well as non-consensual touch and even sexual abuse. Considering that sexual abuse is the most underreported crime, we expect the known allegations are just the tip of the iceberg (Allen, 2007; National Sexual Violence Resource Center, 2017).

There are numerous reasons why sexual assault survivors do not report their experiences, and these reasons are further amplified when one was abused during a mind-altering psychedelic session. For instance, many of these participants are using psychedelic therapy to heal from trauma. Traumatic experiences can shatter one’s view of the world as a safe place, violate a person’s understanding of healthy boundaries, and distort one’s ability to trust others (Biruski et al., 2014). Within trauma therapy, a therapist’s role is to help their client re-establish a sense of safety and connection within the world, which includes modeling healthy attachment and appropriate boundaries between therapist and client. In the “four Rs” approach to trauma-informed care, clinicians are taught to “resist retraumatization” when treating clients, meaning that they must take active and ongoing steps to understand trauma and to ensure that clients are not further traumatized within any aspect of their care (Goddard, 2020; Selywn & Lathan, 2020; Substance Abuse and Mental Health Services Administration, 2014).Clearly, sexually abusing a client who is seeking trauma therapy to heal from rape, as was the case for Meaghan Buisson, does not follow the principle of resisting retraumatization (Goldhill, 2020). To be blunt, Meaghan’s story, which includes years of not being believed, provides an excellent example of why so many survivors do not wish to step forward: They do not perceive that the systems in place will believe or respect them, much less work to ensure justice.

There are absolutely no circumstances within a therapeutic context in which sexual contact is permissible; this is clear in every code of ethics in the helping professions. Given the power imbalance that exists between practitioners and clients, it is always the practitioner’s responsibility to maintain professional boundaries while looking out for the best interest of the client. Thus, a client cannot consent to sexual contact with their therapist, and any sexual touch that occurs is therefore considered abuse (Goldhill, 2020; Province of Ontario, 1991). It is entirely the therapist’s responsibility to ensure that no sexual boundaries are violated. Nonetheless, when Meaghan Buisson reported her MAPS psychedelic guide Richard Yensen for sexual assault, Yensen did not uphold his ethical responsibility to maintain sexual boundaries when he admitted to having a sexual relationship with Buisson. He reported that it was initiated by Buisson, whom he described as a “skilled manipulator” (Lindsay, 2021, para. 16). MAPS has publicly condemned Yensen’s behaviour, but they have taken little action to reconcile the harm that was done to Buisson, not to mention other clinical trial participants who have identified feeling significantly distressed and even suicidal following their MDMA clinical trial (Tillett Wright, 2022b). While MAPS has a “two-therapist protocol” reportedly for the safety of the participants, only one of the two therapists is required to be licensed (MAPS, 2021b). This has apparently provided MAPS with an opportunity to deflect blame, as Yensen did not have duty of care over the trial participants.

Trauma continues to accumulate for participants when their reports of feeling harmed by psychedelic therapies are ignored or dismissed, and when they are blamed and labeled as “crazies” (Hall, 2021a, para. 22). When the institutions that are intended to protect these individuals also fail to respond, this feels like a “second assault” for survivors (Smith & Freyd, 2014, p. 575). In fact, known as institutional betrayal, Smith and Freyd (2013, 2014) found that when institutions fail to respond supportively to the individuals who trust and rely upon them, their symptoms of trauma worsen. Individuals who are engaging in experimental and controversial treatments bestow a deep level of trust upon the therapists who are treating them. They are also trusting the systems that support these therapists to prioritize their best interests. After his own experience of abuse within psychedelic therapy, Will Hall (2021b) shares his story publicly and emphasizes the responsibility of therapists to protect their clients from betrayal. But instead of protecting their clients, therapists accused of abuse are using their client’s vulnerabilities against them by stating that it is the client’s resistance and past traumas that are causing them to question the therapist’s methods, which the therapist claims are “healing” (MacBride, 2021).

Moral Disengagement

The idea that practitioners are healing participants via wayward methods of delivering psychotherapy may best be described as moral disengagement. This is the sociopsychological phenomenon in which individuals convince themselves that ethical standards do not apply to them because they presume that their harmful behaviour is serving a worthy cause, and thus they feel absolved of any responsibility (Bandura, 2016). This is certainly the stance that married couple Aharon Grossbard and Françoise Bourzat appear to maintain after several allegations of sexual abuse and ethical misconduct have been made against them. In an interview with best-selling author Michael Pollan, Grossbard admits that he does not follow the rules of psychotherapy when he hugs and touches his clients (Hall, 2021a; Pollan, 2019). In this case, Grossbard acknowledges that he is crossing a boundary which suggests that he believes that he is above the rules. Most concerningly is that these are preparatory behaviors for future sexual transgressions that he can then argue are just a part of the therapy, as he has done before (Hall, 2021a). Pollan (2019) writes that psychedelic-induced mystical experiences may lead to an inflated ego, whereby some people come to believe that they have been chosen for great things. This may have been the case with Grossbard and Bourzat, both of whom continue to deny any wrongdoing despite admissions of previous sexual transgressions with other clients (they appear to still be in practice, while their daughter now purportedly runs the Center for Consciousness Medicine that they founded) (Center for Consciousness Medicine, 2021; Lace v. Grossbard, 2001).

After Hall (2021b) publicized his own accounts of abuse by Grossbard and Bourzat, MAPS responded by claiming to have reviewed their own practices and policies in the interest of protecting participants. Ironically, their Code of Ethics does not seem to reflect their actual practices given that they claim to “never abandon a participant” (Multidisciplinary Association for Psychedelic Studies [MAPS], 2021, p. 2), which contradicts the experiences of participants whose cries for help following their MDMA clinical trials went ignored by MAPS (Tillett Wright, 2022a). If researchers like those at MAPS, therapists, and other leaders in this field truly have the good intentions that they claim, one would expect they would be equally committed to engaging with participants who report having been harmed in order to find ways to do better. After all, MAPS states that they “subscribe to the value of humility” and “commit to ongoing personal and professional self-reflection regarding ethics and integrity” (MAPS, 2021, p. 5). If this is true, it is puzzling that MAPS and psychedelic therapists alike would not also assist participants who were hurt by their therapists and seek to do better to prevent further harm. From a scientific perspective, it is deeply worrisome that researchers are not more attentive to results that falsify their hypothesis, highlighting bias within the research.  

What Can Be Done?

Interestingly, among all the reports of sexual abuse and ethical misconduct within psychedelic therapies, the concerns being raised are not about the psychedelic substance itself, but about the therapy that is accompanying it. From our review of the relevant media, many survivors of these abuses agree that psychedelics have the potential to be a powerful healing agent, but that such a powerful substance needs to be handled with great care and responsibility. Similarly, most psychedelic therapists and guides would agree that their goal is to help people, not to further traumatize them. Yet it is also clear that the code of ethics that governs MAPS therapists, which appears thoughtful and detailed at first glance, is not enough to prevent abuses such as those committed by Yensen and Dryer, nor to prevent other, less overt harm by therapists. Given that psychedelic therapy is still in its experimental phase, it is critical to establish safe and effective ways to include these substances within a therapeutic context.

If we can agree that a central goal of this movement is to heal trauma, then we can also agree that those who are seeking this treatment must actually be heard, understood, and respected when they point out what is helpful and what is harmful. This means that survivors are not simply regarded as outliers or collateral damage when their treatment does not work. Importantly, they should not have to engage in the level of self-advocacy that Buisson, Hall, Ross, and others have had to do to address the abuse that they experienced. We must understand that false sexual abuse allegations are rare, and therefore when survivors come forward about their experiences, that these are believed and validated (Belknap, 2010; Ferguson & Malouff, 2016; Lisak et al., 2010). Believing survivors does not equate to labeling the accused as guilty. Instead, it demonstrates support towards survivors and an agreement to take their claims seriously while collaborating on a just solution. Best practice guidelines for treating individuals who have sexually abused assert that the “rights and interests of victims and their families are of paramount consideration” (Association for the Treatment of Sexual Abusers, 2014, p. 5). While solutions should be survivor-driven, they can also support opportunities for those who have sexually harmed to take accountability. Decades of research shows that confrontation does not work to elicit behaviour change, much less responsibility-taking (Moyers et al., 2005; Resnicow, & McMaster, 2012). In fact, if cancel culture has taught us anything, it is that there is no graceful opportunity to recover from one’s worst mistakes; instead, it often seems that those who harm simply end up in different positions of authority elsewhere. When punishment, career loss, legal recourse, and ostracization are at stake, what would motivate someone to take accountability?

In the interest of returning to the Indigenous roots of plant-based healing that modern approaches emulate, there are many important lessons that can support this movement’s direction down a safe and equitable path. This article cannot possibly outline all of these lessons nor do justice to the various Indigenous cultures that have disseminated such knowledge. Accordingly, the authors believe that it is essential for Indigenous voices to be actively leading the conversations on plant-based healing, and for the mental health profession that is borrowing these practices to consider the exploitation of plant medicines that is taking place.  Further conversations about decolonizing psychedelic practices are vital for us to be able to use psychedelic medicines ethically.

“Two-Eyed Seeing” was introduced by Mi’kmaq Elders, Albert and Murdena Marshall, as a guiding principle to bring together Indigenous and Western ways of knowing to benefit from the strengths of many perspectives (Wright et al., 2019). By blending psychedelic science with Indigenous ways of knowing, this field could greatly benefit, but it must be borne of a genuine desire to do so. For one, reconciliation cannot be defined by those who caused harm (which again emphasizes the need for survivor-led solutions) (Blackstock, 2009). A restorative justice approach, which has roots in Indigenous teachings, can be a powerful healing aid (Chartrand & Horn, 2016; Gaudreault, 2005; Leung, 1999). Restorative justice seeks to repair relationships and alleviate harm by including those who have caused the harm and those who have been harmed, while the community surrounds them. It is important to note that restorative justice can only be effective when enacted with utmost preparation and once the accused can acknowledge their responsibility; thus, such an approach would not be successful in the cases already mentioned above (Gaudreault, 2005; Pranis, 2014; Restorative Justice Exchange, 2022). However, if a safe space can be established to support both the victim and the accused, “circles” are a type of restorative justice used by Indigenous peoples to restore balance in a community after harm has occurred (Stevenson, 1999). To promote a safe and respectful space, circles must be led with “patience, humility, deep listening, [and] acceptance of everyone as worthy of respect” (Pranis, 2014, p.3).

There are some commonly shared insights that emerge from psychedelic experiences that actually parallel certain Indigenous belief systems, such as a deep sense that there is something greater “out there,” a greater respect of the natural world, and an understanding that all life is interrelated (Blanchard, 2020; Kimmerer, 2016). This sense of knowing in part influences the strong value of community that many Indigenous cultures share, and these values may be a powerful catalyst for change within the current psychedelic renaissance (Blanchard, 2020; Kimmerer, 2016). We all have a role to play if we want this movement to be safe and efficacious. We all agree that we wish for this field to exist free from sexual abuse. Sexual abuse in therapy is not unique to the psychedelic world, but it is especially worrisome when it occurs under the influence of mind-altering substances that purport powerful healing, as these substances increase a person’s vulnerability to bad and even dangerous therapy. Individuals who choose to engage in such healing should be protected, and those leading these healing journeys should be rigorously trained, regulated, and supervised to ensure such protection. Blackstock (2009) argues that good intentions are not enough, and that in the case of social workers, the fear of causing harm under the guise of good intentions is so great that it leads to turning a blind eye when such harm does occur. Accordingly, we must unite over the goal that all who are invested in psychedelic therapy do hold good intentions, and for exactly that reason we must follow through with good actions.

What’s Next?

In our opinion, it’s time for all professional credentialing bodies to review what is happening with respect to psychedelic therapy abuses and strategize in advance. The momentum surrounding these drugs continues to increase, and unless mental health professionals and the professions themselves start to include discussions about how to keep these therapies safe, we should expect more harm.

As long as money is at stake (as is the case with MAPS research), we can also expect problems to persist. When there is significant evidence demonstrating that a treatment is harmful, Botanov et al. (2022) suggest that these concerns should be reviewed and that “clinical scientists and practitioners (including those who are not users of the treatment) [should be consulted] before providing it with additional support and resources” (para. 29). Further, Botanov et al. (2022) argue that “[p]olicymakers, funders and government agencies need to be aware that some of the interventions they are fiscally supporting may be ineffective or potentially harmful” (para. 29).

Public discussion about the dangers of working with unregulated professions is also important. Individuals who style themselves as life coaches and psychedelic guides are placing themselves and others at risk unless they, too, adhere to strict codes of ethics and guidelines of practice.

More work is needed to bring survivors’ voices to the table. It is appalling that so many voices go unheard and disrespected when there is so much they could teach us about the practices that so many are researching and promulgating. An independently conducted phenomenological exploration of their experiences in psychedelic therapy/clinical trials is urgently needed to supplement the quantitative findings and better understand the dynamics at play. Further study into informed consent and the role of client autonomy in psychedelic therapy will also be welcome.

One practical approach that can help to ensure safety would be to include the client’s feedback on the process in every encounter, from start to finish. Considerable research has shown how collecting client feedback can improve outcomes and prevent harm (Prescott, Maeschalck, & Miller, 2017; 2022). Even this approach, however, requires good faith attempts by all involved to honor the client’s voice in treatment.

Prior to taking the field forward, extensive training of all professionals will be vital to prevent harm. This training could involve reflective practice (for example, critically reflecting on one’s own skills and being alert to countertransference reactions) and ensuring that all professionals have ongoing supervision from professionals who are more experienced and established. One very important issue in considering training is that too many of those who have historically provided this training have themselves caused significant harm, including sexually abusing those they are training as well as treating. Notably, until everyone can recognize the harm that has already been caused by these therapies, more training will not produce any meaningful change.

Crucial to this work will be a strong value on leaving no one harmed. Referring dismissively to clients as “skilled manipulators” and having borderline personality disorders only serves to judge and rank order human beings, which is in direct opposition to all established codes of ethics, empirically sound treatment methods, and the spirit in which most psychedelic therapies—indeed, all therapies—operate. Skilled clinicians know this and can help other emerging professionals to learn it.


In the field of directly treating trauma, one never knows where the next innovation will come from. The authors have no stake in the outcome of psychedelic therapy research. What is clear, however, is that people are not only being harmed, but are being dismissed as outliers when they could be allies. The field of trauma therapy has much to offer to prevent vulnerable lives being cast aside. It is critical that attempts to improve psychedelic therapies be implemented not only with fidelity to the models and protocols, but with a deep respect for all clients’ experiences and without dismissing their concerns.

1 We are grateful to those survivors of abuse in psychedelic therapy who offered their ideas, feedback, and experiences on earlier drafts of this article. While most have wished to remain anonymous, they have all made this article stronger.

2 Authors’ note: We use the term “Indigenous” throughout this article and wish to convey that we are using this term in its broadest sense. We recognize that there is great diversity in all Native cultures worldwide. We further wish to acknowledge that we are not ourselves part of any Indigenous culture, and that we live on the unceded lands of many nations.

3 Author’s note: We were privileged to interact with several individuals who experienced harm in psychedelic therapy and research while writing this article. While every individual’s story is unique and important, we cannot do justice to them all here, so we will highlight some of the general themes along with the most known cases currently within the media.

 The authors have no financial interests to declare.


Allen, W. D. (2007). The reporting and underreporting of rape. Southern Economic Journal, 73(3), 623–641.

Association for the Treatment of Sexual Abusers. (2014). ATSA practice guidelines for the assessment, treatment, and management of male adult sexual abusers. ATSA. Beaverton, OR.

Bandura, A. (2016). Moral disengagement: How people do harm and live with themselves. Worth Publishers, Macmillan Learning.

Belknap, J. (2010). Rape: Too hard to report and too easy to discredit victims. Violence Against Women, 16(12), 1335–1344.

Biruski, D. C., Ajdukovic, D., & Stanic, A. L. (2014). When the world collapses: Changed worldview and social reconstruction in a traumatized community. European Journal of Psychotraumatology, 5(1), 24098.

Blackstock, C. (2009). The occasional evil of angels: learning from the experiences of Aboriginal peoples with social work. First Peoples Child & Family Review, 4(1), 22-31.

Blanchard, G. T. (2020). Awakening the healing soul: Indigenous wisdom for today's world. Center for Peace Research.

Botanov, Y., Williams, A., Sakaluk, J. (2022, May 19). Bad therapy. Aeon.

Carey, B. (2019, September 6). Tim Ferriss, the man who put his money behind psychedelic medicine. The New York Times.

Center for Consciousness Medicine. (2021, November 18). Some facts about the Center for Consciousness Medicine. The Center for Consciousness Medicine.

Chartrand, L., & Horn, K. (2016, October). A report on the relationship between restorative justice and Indigenous legal traditions in Canada. The Department of Justice Canada.

Encyclopaedia Britannica (Ed.). (2022, May 27). Timothy Leary. Encyclopædia Britannica.

Ferguson, C. E., & Malouff, J. M. (2016). Assessing police classifications of sexual assault reports: A meta-analysis of false reporting rates. Archives of Sexual Behavior, 45(5), 1185–1193.

Forbes Magazine. (2022, May 29). Real time billionaires. Forbes.

Fotiou, E. (2020). The role of Indigenous knowledges in psychedelic science. Journal of Psychedelic Studies, 4(1), 16-23.

Gaudreault, A. (2005). The limits of restorative justice. Government of Canada.

George, J. R., Michaels, T. I., Sevelius, J., & Williams, M. T. (2020). The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and ethnic minority inclusion, Journal of Psychedelic Studies, 4(1), 4-15.

Gerber, K., Flores, I. G., Ruiz, A. C., Ali, I., Ginsberg, N. L., & Schenberg, E. E. (2021). Ethical concerns about psilocybin intellectual property. ACS Pharmacology & Translational Science, 4(2), 573–577.

Goldhill, O. (2020, March 3). Psychedelic therapy has a sexual abuse problem. Quartz.

Goddard, A. (2020). Adverse childhood experiences and trauma-informed care. Journal of Pediatric Health Care, 35(2), 145–155.

Hall, W. (2021a, September 18). Psychedelic therapy abuse: My experience with Aharon Grossbard, Francoise Bourzat… and their lawyers. Medium.

Hall, W. (2021b, September 25). Ending the silence around psychedelic therapy abuse. Mad In America.

Kabil, A. (2017, January 6). This Mexican medicine woman hipped America to magic mushrooms, with the help of a bank executive. Medium.

Kimmerer, R. W. (2016). Braiding sweetgrass. Tantor Media, Inc.

Lace v. Grossbard (2000). Case No. CGC 00 316637. Superior Court of California, County of San Francisco,

Leung, M. (1999). The origins of restorative justice.

Lindsay, B. (2021, March 18). As psychedelic therapy goes mainstream, former patient warns of danger of sexual abuse. CBC News.

Lisak, D., Gardinier, L., Nicksa, S. C., Cote, A. M. (2010). False allegations of sexual assault: An analysis of ten years of reported cases. Violence Against Women, 16(12), 1318–1334. doi:10.1177/1077801210387747

Mac, G. (2021, January 26). The psychedelic miracle. Rolling Stone.

MacBride, K. (2021, November 16). "Aharon said it was healing:" How psychedelic therapy was undermined by abuse. Inverse.

Moyers, T. B., Miller, W. R., Hendrickson, S. M. L. (2005). How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions. Journal of Consulting and Clinical Psychology, 73(4), 590–598. doi:10.1037/0022-006X.73.4.590

Musk, E. [@elonmusk]. (2022, April 30). I’ve talked to many more people who were helped by psychedelics & ketamine than SSRIs & amphetamines [Tweet]. Twitter.

Multidisciplinary Association for Psychedelic Studies. (2021, January 7). MAPS code of ethics for psychedelic psychotherapy (Version 4).

National Sexual Violence Resource Center. (2015). Statistics about sexual violence. NSVRC.

Nomoto, S. (2020, June 2). Indigenous cultures that used psychedelic plants. TruHavn.

Pollan, M. (2019). How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. Penguin Books.

Pranis, K. (2014). Circle Keeper’s Handbook. Edutopia.

Prescott, D. S., Maeschalck, C. M., & Miller, S. D. (2017). Feedback-Informed Treatment in Clinical Practice: Reaching for Excellence. Washington, DC: American Psychological Association.

Prescott, D. S., Maeschalck, C. M., & Miller, S. D. (2022). Feedback-Informed Treatment. In R. Fulmer (Ed.), Counseling and psychotherapy: Theory and beyond. San Diego, CA: Cognella.

Province of Ontario. (1991). Regulated Health Professions Act. Ontario. S.O. c. 18.

Resnicow, K., & McMaster, F. (2012). Motivational interviewing: moving from why to how with autonomy support. The International Journal of Behavioral Nutrition and Physical Activity, 9(19).

Restorative Justice Exchange. (2022). Three core elements of restorative justice. Restorative Justice.

Ross, Lily K. (Host). (2021, December 7). That’s an old story (No. 2) [Audio podcast transcript]. In Cover Story. The Cut.

Ross, Lily K. (Host). (2022a, March 2). Open-heart surgery (No. 6) [Audio podcast transcript]. In Cover Story. The Cut.

Ross, Lily K. (Host). (2022b, March 8). Political science (No. 7) [Audio podcast transcript]. In Cover Story. The Cut.

Ross, Lily K. (Host). (2021-2022). Cover Story: Power Trip. [Audio podcast]. VoxMedia.

Selwyn, C. N., & Lathan, E. (2020). Helping primary care patients heal holistically via trauma-informed care. The Journal for Nurse Practitioners, 17(1), 84–86.

Sessa, B. (2006). From sacred plants to psychotherapy: The history and re-emergence of psychedelics in medicine. Royal College of Psychiatrists Special Symposium on: Psychosis, Psychedelics and the Transpersonal Journey.

Sharma, S. (2021, October 11). On sacred reciprocity: Giving back to our Indigenous predecessors in the psychedelic movement. Psychedelic Spotlight.

Simon, R. (Ed.). (2018). Psychedelics: the future of talk therapy? Psychotherapy Networker.

Smith, C. P., & Freyd, J. J. (2013). Dangerous safe havens: Institutional betrayal exacerbates sexual trauma. Journal of Traumatic Stress, 26(1), 119–124.

Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal. American Psychologist, 69(6), 575–587.

Stevenson, J. (1999). The circle of healing. Native Social Work Journal, 2(1), 8–21.

Substance Abuse and Mental Health Services Administration. (2014, July). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Vargas, A. S. (2017, February 23). Meet María Sabina, the Oaxacan Curandera who brought magic mushrooms to '60s counterculture. Remezcla.

Wasson, R.G. (1957, May). Seeking the Magic Mushroom. The Psychedelic Library.

Wright, A. L., Gabel, C., Ballantyne, M., Jack, S. M., & Wahoush, O. (2019). Using Two-Eyed Seeing in research with Indigenous people: An integrative review. International Journal of Qualitative Methods.


How to Treat Youths who have Committed Sexual Offenses

by David Thornton, Ph.D.

Research into the effectiveness of different kinds of treatment for individuals who have committed sex offenses is surprisingly rare in recent years. Part of this is because it is hard to do. The low base rate of sexual recidivism makes it hard to have large enough samples to detect even relatively substantial treatment effects. And to interpret the recidivism rate observed for a treatment group you need some comparison group that they can be contrasted with, a group that either is not treated, or which is treated differently. This is hard to arrange. Withholding treatment from people who are assessed as presenting a “high risk” for sexual recidivism is hard to justify, but if you don’t do that, how do you ever find out whether the treatment actually helps. Ensuring the comparison group is genuinely comparable to the treatment group prior to treatment is not easy but if you don’t ensure comparability any result will be misleading.
Sometimes I get the impression that researchers have decided the topic is just too hard to study and moved on to doing something easier. The problem is that, in the absence of guidance from research, changes in treatment practice simply become a matter of what is fashionable. Following fashion can create the illusion of progress but an illusion is all it is.

While thinking such gloomy thoughts, I was pleasantly surprised to see a few recent papers that spoke to the effectiveness of different kinds of treatment. The most striking of these is by Aebi et al. (2022). It speaks to the effectiveness of different kinds of treatment for juvenile males who have sexually offended and is notable for both having a sound methodology and informative results.

Objectives of the Paper

The purpose of the paper was to compare the effectiveness of two different methods of treating juvenile males who have committed sexual offenses.

The first program, called Therapy Program for Adequate Sexual Behaviors - I (ThePaS-I), focused on understanding the individual’s sexual offense and developing offense-specific skills. These included accepting responsibility for the offense, developing the individual’s awareness of triggers, identifying and practicing internal and external behavioral controls, and developing a relapse prevention plan. This program is offense specific and draws heavily on traditional adult approaches to treating men who have committed sexual offenses.

The approach adopted by ThePaS-I is very consistent with what was originally advocated by Ryan & Lane (1997) when treatment for juveniles who had committed sex offenses was first being developed. More recently, Dopp et al. (2015) criticized this use of adult derived offense-specific treatment with juveniles. Current thinking has emphasized developmental issues common across adolescents with different kinds of problem behavior. Caldwell’s work (e.g., Caldwell, 2016) in particular has emphasized that juveniles who have committed a sexual offense rarely reoffend sexually and they are much more likely to engage in other kinds of criminal behavior. Caldwell states that for more recent releases the juvenile sexual recidivism rate is under 3%.

The second program, ThePaS-II, was designed to be consistent with this critique. It aimed to develop more general social, emotional, and psychological skills. It was adapted from the mindfulness training literature and social competence therapy for adolescents. Consequently, it taught many skills designed to help individuals achieve their goals in non-offending ways but did not require attention to the specific sexual offense the individual had committed.

Both programs were designed out of the University Hospital of Psychiatry Zurich and were of similar duration, involving about 19 or 20 modules, and about 30 sessions each lasting 60 minutes. They were both run by psychotherapists with at least master’s level training in psychology using treatment manuals and working under supervision. Importantly both treatments were administered by child and adolescent psychotherapists in a therapeutic, supportive, respectful, age-appropriate manner. Both programs could be run for individuals or for small groups of up to six participants.

Methodological Issues

Who participated in the study?
Participants were youth who had been referred by juvenile justice authorities to three forensic mental health institutions between 2011 and 2017. Inclusion criteria were that they had committed “crimes against sexual integrity” as defined by Swiss law (except for “pornography offenses”) and were aged 10 to 18 at the time of the first sex offense. Exclusion criteria were IQ below 70, insufficient knowledge of the German language, had engaged in severe non-sexual violence, had an acute psychotic disorder, a major depression, or a paraphilic disorder, or received previous treatment by ThePaS program.

Number of participants

75 youth were referred to treatment, 3 met exclusions criteria, 7 did not consent to participate in the study, 1 individual had to be later excluded because of a computer error, leaving a final sample of 64 participants. Mean age at time of the index offense was 14.75 and 15.15 at the time of pretreatment assessment.

How were comparable groups created?
All participants went through pre-treatment assessment and then were assigned between the two treatment groups using covariate adaptive randomization (see Suresh, 2011). This process uses randomization to assign cases. As assignment progresses future assignments take into account any differences between groups on pretreatment variables and makes the next assignment in a way designed to reduce these differences. This maximizes the similarity of the groups assigned to the two treatments.

How was treatment integrity assessed?
After each session was completed, it was coded by the therapist for fidelity (did the youth turn up and were the session contents consistent with the manual) and success (therapists’ impression of how well the youth understood and benefited from the session).

How was recidivism measured?
Criminal recidivism after treatment over an average follow up of about 4 years was derived from two sources. First, they looked at official records of reoffenses. Second, the researchers had access to juvenile justice case files which included reports from supervisors, institutions, and others who had post-treatment contact with the youths. These case files were reviewed to identify any behavior that could have been charged under Swiss law, regardless of whether it had been charged. Two categories of criminal recidivism were considered: sexual recidivism (excluding illegal pornography) and general recidivism. Importantly, the raters reviewing the files did not know which treatment program the youths had participated in.

Which other outcomes were assessed?
Internalizing and externalizing mental health problems were assessed using the Youth Self-Report questionnaire. Two scales from the Multiphasic Sex Inventory Adolescent Male form were used to assess sexual knowledge and beliefs as well as problems with sexual confidence. Beliefs about victims’ experiences were assessed through the Victim Empathy Questionnaire for Adolescents. These measures were taken prior to treatment, immediately after treatment, and 12 months after treatment.

The most important findings are as follows. Note that I have only stated that there was a difference in outcomes between groups when this difference was statistically significant. I have avoided going into the intricacies of statistical analysis, but, for example, the recidivism data were analyzed with Cox Regression which allows covariates to be controlled and allows for time at risk.

  1. Therapists’ ratings of fidelity and success were high for both programs but a little higher for the offense-specific program (ThePaS-I).

  2. Youths’ ratings of satisfaction with treatment success were generally positive but materially lower for the offense-specific program (ThePaS-I).

  3. Self-reported internalizing problems declined during both treatment programs, but self-reported externalizing problems declined only during ThePaS-II. Externalizing problems did not decline during the offense-specific treatment.

  4. About half of both groups had some form of criminal recidivism during the follow up period.

  5. Sexual recidivism was much lower after offense-specific treatment (ThePaS-I). Rates of sexual recidivism were 8.6% after ThePaS-I and 31.0% after ThePaS-II.

Practice Implications

At least some groups of juveniles are more likely to sexually recidivate than might be supposed based on Caldwell’s publication (Caldwell, 2016). Sexual recidivism from official sources was 8% overall in the present sample, and when sexual offenses identified from case files were added in, it was 19%. It seems that Caldwell’s reliance on official charges may have underestimated about half of identifiable sexual reoffending. Nevertheless, the fact that these youth were referred by juvenile justice authorities for specialized treatment by a forensic mental health agency likely made them a “high-risk high-need” sample which would be expected to have a higher sexual recidivism rate.

The main practice implication of the study is that how you focus treatment effort determines which outcomes you affect. The offense specific program was better at reducing sexual recidivism but worse at reducing general externalizing behavior. The more general treatment program was better at reducing externalizing behavior but worse at reducing sexual recidivism. Critically, if you want to reduce sexual recidivism, your intervention should include work on the specific offense the person has committed and the development of attitudes, knowledge, and skills specifically relevant to avoiding offenses of that kind.


Aebi, M., Krause, C., Barra, S., Gunnar, V., Vertone, L., Manetsch, M., Imbach, D., Endrass, J., Rossegger, A., Schmeck, K., & Bessier, C. (2022). What kind of therapy works with juveniles who have sexually offended? A randomized-controlled trial of two versions of a specialized cognitive behavioral outpatient treatment program. Sexual Abuse. Online First: March 2022.

Caldwell, M. F. (2016). Quantifying the decline in juvenile sexual recidivism rates. Psychology, Public Policy, and Law, 22(4), 414.

Dopp, A. R., Borduin, C. M., & Brown, C. E. (2015). Evidence-based treatment for juvenile sexual offenders: review and recommendations. Journal of Aggression, Conflict and Peace Research, 7, 223-236.

Ryan, G. D., & Lane, S. L. (1997). Integrating theory and method. In G. D. Ryan, & S. L. Lane (Eds.), Juvenile Sexual Offending: Causes, Consequences, and Correction (pp. 267–321). Wiley.
Suresh, K. (2011). An overview of randomization techniques: An unbiased assessment of outcome in clinical research. Journal of Human Reproductive Sciences, 4(1), 8. 

Child and Adolescent Committee

by Amanda Pryor and Arliss Kurtz

When Shakespeare commented, “What’s in a name? A rose by any other name would smell as sweet”, he meant that a name is irrelevant because the entity would still be the same even with a different name. While this may be true, sometimes a name does not accurately encompass all that an entity is and has to offer. As many of you already know, ATSA recently underwent a name change to become the “Association for the Treatment and Prevention of Sexual Abuse” to reflect the scope of work ATSA members do to make society safer. So too, the members of the Juvenile Practice Committee also decided a name change was needed to reflect the broad age and developmental stages of the youth, from young children to young adults, with whom we work. With that in mind, the Juvenile Practice Committee became the Child and Adolescent Committee to start 2022 with a fresh perspective. While both entities inherently remain the same, the new names are more inclusive and relevant to the work we all do.

The Best Practices sub-committee has been busily reviewing and updating previous fact sheets completed by the formerly named, Juvenile Practice Committee.  As noted on the Juvenile Practice page of the ATSA website, these brief fact and informational materials are intended to help inform and guide best practice in working with children and adolescents who have engaged in abusive or problematic sexual behavior. We are pleased to announce that the 2015 document previously titled, “Assessment and Treatment of Adolescents with Intellectual Disabilities Who Exhibit Sexual Problems or Offending Behaviors” has been updated and renamed, “Assessment and Treatment of Adolescents with Intellectual Disabilities Who Exhibit Sexual Problems” by the lead authors, Gerry Blasingame, Kevin Creeden, and Phil Rich.

The Child and Adolescent Committee has committed to using person-first language to name the behavior and not label the person who engaged in it. In keeping with the ATSA Adolescent Guidelines, the Child and Adolescent Committee uses the descriptor “adolescents who have engaged in sexually abusive behavior” in all new documents and those in review. In addition to this being person-first language, it denotes that this is past, rather than current or future behavior, thereby focusing on the potential for positive change.

The In-Reach subcommittee continues to host monthly, virtual “JUMPP” events that are intended to be an interactive experience driven not only by the information our peer consultants share but also by participants’ questions, ideas, experiences, discussion, and case consultations. JUMPP is the acronym for “Juvenile Meeting Place for Practitioners.” Although our full committee’s name has changed, we opted to keep the juvenile in JUMPP for the sake of brand and to avoid the acronym “CAMPP” (although the tag line that we would meet together at “CAMPP” was tempting!)  The JUMPP events continue to focus on topics of interest to our participants.  Over the next quarter, we plan to become more inclusive of international topics, speakers, participants, and hosting in international time zones. Information about upcoming JUMPP events is sent out by ATSA Public Affairs Coordinator, Aniss Benelmouffok, to the membership and posted to the Juvenile Page on the ATSA website.

In closing, we hope we have piqued your interest to keep up to date on the activities of the newly named, Child and Adolescent Committee!

Membership Committee

by Amber Butt, LAC

The Membership Committee started the ATSA Fellow in 2015 as a way to honor ATSA members who have demonstrated allegiance to their profession and a strong commitment to the ongoing work of the Association.  A Fellow of ATSA goes “above and beyond” in regard to their dedication and contribution to ATSA.  The ATSA Fellow designation is an enhancement to their professional credentials and is recognized by their colleagues in ATSA as a member of a select group, currently comprising approximately 5% of ATSA membership.

At this time, the Membership Committee has chosen to begin spotlighting a few of the ATSA Fellows in each of the Forum editions as a way of honoring them as members and people who have contributed to our field. Below are the first two individuals selected to spotlight.

Dr. Liam Marshall - ATSA Fellow 2016

Dr. Liam Marshall has been a longstanding ATSA member. He has given more than 40 presentations at ATSA Annual Conferences including 3 preconference workshops. He has delivered one-day workshops for New Jersey, Arizona, and Virginia chapters of ATSA, and keynote addresses for state chapters of ATSA including MnATSA (2011, 2016) and MARATSA (2016). Dr. Marshall has extensive published works including, but not limited to, many articles in the SAJRT and numerous published articles on sexual offense assessment and treatment in other (non-SAJRT) peer-reviewed professional journals. Additionally, he has reviewed more than 30 articles for SAJRT. Dr. Marshall has served on the ATSA Membership Committee and contributed to discussions held in a number of other committees. Of all his works, Dr. Marshall may be best known for being the founding lead singer and guitarist of AUDIO-philia, the ATSA house band. Thank you, Liam, for all of your scholarly and musical contributions to the organization!

Joan Tabachnick, MBA - ATSA Fellow 2015

Joan Tabachnick has served for two terms on the ATSA board. She has co-chaired the Strategic Planning Committee and was the co-founder of the ATSA’s Prevention Committee. She has served as the Executive Director of MASOC and the contact person for MATSA. Joan regularly presents at ATSA Annual Conferences in addition to local conferences on issues related to policy and prevention. She has been published in SAJRT and in the Forum on prevention, bystander intervention, public policy, and other related topics. She has been published in several other journals related to sexual abuse prevention, many newsletters, book chapters, and co-authored the ATSA publication, A Reasoned Approach. Joan began a strategic planning process that led to a victim advocate representative on the Board of Directors, the creation of the Prevention Committee, and the Gail Burns Smith Award. Joan has been described by her colleagues as passionately committed to prevention and bystander work, and is task focused, tireless, and humble. Thank you, Joan, for your dedication to prevention and victim advocacy! 

Membership Coordinator for ATSA

May 31st 2022


About the Organization

The Association for the Treatment and Prevention of Sexual Abuse (ATSA) is an international, nonprofit, multi-disciplinary organization dedicated to making society safer by preventing sexual abuse. ATSA promotes sound research, effective evidence-based practice, informed public policy, and collaborative community strategies that lead to the effective assessment, treatment, and management of individuals who have sexually abused or are at risk to abuse.

ATSA's membership consists of approximately 3000 professionals including: treatment providers, researchers and educators, victims' rights advocates, law enforcement and court officials, and representatives of many other stakeholder groups. The core values that guide ATSA are professional excellence, prevention of sexual abuse, collaboration with different organizations, and advocacy for the prevention and treatment of individuals who sexual abuse. ATSA promotes the philosophy that empirically based assessment, practice, management, and policies?enhance community safety, reduce sexual recidivism, protect victims and vulnerable populations, transform the lives of those caught in the web of sexual violence, and illuminate paths to prevent sexual abuse.


Position Summary

Report: Associate Director

FLSA Status: 1 Year Contract Full Time open for automatic renewal for one year

Travel: Several times a year

Salary: $25 -$28 per hour depending on experience

Benefits: Medical/Dental insurance, PTO, SEP (after first year)

Place of Work (primarily remotely): Travel to the Beaverton, Oregon office will be necessary with scheduled visits to the office to be determined based on the applicant’s location

Application closes June 16th 2022

The Membership Coordinator plays a key role in developing and communicating the value of ATSA membership to potential and current members.  As such, key duties revolve around:  recruiting, engaging, and retaining ATSA members, supporting ATSA Chapter development and maintenance, processing membership records, tracking and maintaining membership records, data and database management, production of key membership communications, monitoring the growth and change of the ATSA membership, generating reports to update ATSA’s Executive Board and membership, and coordinating with design and printing professionals to prepare membership media materials. This position is central to making members feel welcome and plays a key role in building and conveying the value of membership with ATSA.  


Duties and Responsibilities

  •  Provide a high level of service to foster strong membership ties and serve as the primary contact for all membership inquiries.

  •  Develop and execute successful strategies to recruit and orient new members; evaluate and report on the effectiveness of all membership and communications efforts;

  •  Work closely with members of the Executive Board of Directors, Committee Chairs, and ATSA staff to communicate the benefits of membership and lead the implementation of email and other marketing efforts to members and potential members;

  •  Participate on the Membership Committee led by the ATAS Membership Chair with an international committee;

  •  Support ATSA Chapters to include chapter development and maintenance;

  •  Manage the membership application process, including determining member category and allocation of membership fees, ensuring member renewals; and upgrading current members’ status;

  •  Coordinate the annual membership appeals and renewals, including preparing and distributing letters/packets and mailing lists;

  •  Collect, analyze, and report membership trends to ATSA staff and the Executive Board of Directors;

  •  Maintain an accurate and complete member data information system;

  •  Assist members of the ATSA Board of Directors and ATSA staff to better understand market size, awareness of ATSA, and prospective member needs;

  •  Assist with communication to members to drive attendance at ATSA conferences and events;

  •  Assist with the development of strategies to increase member’s use of the ATSA website and online resources;

  •  Work with ATSA staff and designers to prepare organizational marketing materials that reflect the depth, reach and impact of ATSA;

  •  Aiding in the development and marketing of fund development campaigns from within the ATSA membership and with external partners.

  •  Process donations including acknowledgment of gifts;

  •  Aid in event registration and lead membership recruitment during events;

  •  Travel out of town to attend the ATSA conferences (national and state conferences) and related events;

  •  Other duties as assigned.


Desired Skills and Experience:

  •  Proficient computer skills, including Word, Excel, Adobe Creative Suites, HTML, member database systems such as CiviCrm;

  •  Data entry and database management;

  •  Experience working in a membership organization (international organizations is exceptional);

  •  Ability to think strategically, anticipating future developments and planning accordingly; proactively identify issues and generate recommendations;

  •  Superior organizational skills and attention to detail; ability to handle multiple tasks simultaneously and balance competing priorities;

  •  Experience planning multi-step projects and reaching milestones on time without sacrificing accuracy and quality;

  •  Excellent written communications skills and ability to express self clearly to both expert and wider public audiences;

  •  Effective verbal communication skills;

  •  An ability to take initiative, demonstrate creativity, be personable and has a high level of professionalism;

  •  An interest and ability to learn new software independently and quickly;

  •  An ideal candidate will demonstrate comfort working independently, as well as part of a team;
    proactively collaborate with ATSA staff, ATSA members and other stakeholders on relevant projects.


To apply for this position, please send a substantive letter of interest and a current CV or resume to

Cybersex Unplugged: Finding Sexual Health in an Electronic World
Weston Edwards, David Delmonico,and Elizabeth Griffin
2011 CreateSpace Independent Publishing Platform 212 pages
ISBN-13:978-1453626450 $22.95 via Amazon (paperback)

Review submitted by Tracy Tholin, Ms.Ed.

Recently, discussion on the ATSA list serve centered around resources for therapists who are working with clients to manage their online sexual behaviors.  Cybersex Unplugged was presented as one option. Reading as both a traditional chapter book, and as a workbook, the text incorporates written client assignments, while also injecting historical and cultural references, including common sense recommendations informed by the authors’ 50 years cumulative experience in the field. While early on the authors note that the workbook can be completed alone, and rapidly, if one so desires, it is most helpful when used in conjunction with a therapist and a support network, with pauses for self-reflection throughout.

Organizationally, the book is divided into four sections, an introduction, followed by three “stages.” In the introduction, the authors acknowledge that while several terms have been used to describe problematic online sexual behavior, they have chosen the term “cybersex compulsivity” to utilize throughout the text (p. 3). The introduction helps the reader explore the question of when online behavior becomes problematic, or compulsive. Juxtaposed against this, the authors present ten components of a sexual health model that both informs the contents of the workbook moving forward and reinforces the goal of becoming sexually healthy, both online and offline. The “conversational” tone of the workbook both lulls the reader and instills confidence moving forward into these heady topics (p. 8).

Stage 1: The Problem Identification Stage will look familiar to anyone who has been facilitating treatment. It includes several components found in traditional treatment programs including language about acting out cycles, high risk situations, thinking errors, feeling triggers, and behavioral analysis. There are several components worth highlighting in this section. First, the early introduction of an “immediate short term prevention plan” establishes safety guidelines for the client who is panicked about his or her behaviors, specifically dubbed “red zone behaviors,” or those that could lead to further serious problems, such as legal ones (p. 13). The Internet Sex Screening Test provides a good measure of “how problematic your sexual behavior might be” (p. 19).   The “offline and online sexual history” assignment is comprehensive and structured, a useful tool during the assessment process (p. 27). Finally, threaded throughout this section and the entire book are helpful metaphors to illustrate important treatment concepts, such as: comparing gathering cookie-baking ingredients to “setups for the acting out cycle,” the wearing of green glasses in the musical Wicked to introduce the concept of “lenses” coloring our view of life, and the use of Shrek and his onion “layers” to discuss “layers of thoughts” leading toward the introduction of thinking errors (pp. 43-49).

At 118 pages, Stage 2: Primary Treatment: Related Topics appears hefty at first glance but addresses several important “underlying issues” propelling compulsive online sexual behavior (p. 75). The authors note that while not every topic applies for every client, they encourage reviewing and prioritizing those that do. Topics encapsulate both the broad and specific such as “culture and stereotypes,” “sexual identity and orientation,” “types and impact of abuse,” “body image,” and “fantasy and masturbation,” to name a few (p. 76). There is also an emphasis on positive sexuality with topics including “assertive communication,” “healthy sexual behaviors” “healing from past relationships” and “desire for intimacy (p.76).”   Particularly noteworthy in this section is the inclusion of questions the client’s partner may ask themselves before the client discloses their problematic behavior. The underlying assumption is that the process will include partners and support people while moving toward healthy, balanced sexuality.  

Stage 3: Setting the Next Step is the shortest section, integrating work done in the first two stages to develop a “continuing care plan” (p. 194). The reader is introduced to “SMART planning” to develop measurable goals (p. 195). Concentric circles provide a framework for identifying “acceptable,” “cautious,” and “unacceptable” behaviors on the internet (p. 204). In the conclusion, the authors emphasize both the ongoing nature of the work, the importance of reviewing the workbook routinely, and the importance of becoming an “expert” on oneself, thereby encouraging self-efficacy. They end on a positive, uplifting note, congratulating the client for doing the work.

Given the rapidly changing face of the internet, the tone of the workbook and the questions the authors ask clients to ponder remain relevant today. The links provided in the book are still active, except two.  The link to a Wikipedia page detailing the history of masturbation is particularly illuminating for the casual reader.

More than one expert in the field, themselves workbook authors, have emphasized the importance of workbooks being one “tool” in a toolbox of interventions, encouraging selection of the pieces that are most relevant for clients. That is the case with this workbook. For newer clinicians it offers a guidebook for assessment and treatment of online sexual behavior problems. For seasoned professionals, it will complement practices you already have in place. Furthermore, the positive psychology framework with which the book was clearly written reduces shame and instills hope for those who are struggling with their online behaviors that healthy sexuality and intimacy can be achieved.  Hence, this would make a worthy addition to your therapist toolbox.

The Correctional Helicopter: How and Why Correctional Agencies Fail to Rehabilitate Offenders
Richard J. Parker, Ph.D.
2022 Tellwell Talent 266 pages
ISBN-13 978-0228873235 Hardcover: $21.38 (Amazon)

Review submitted by David Prescott, LCSW, LICSW

Years ago, a debate raged on ATSA’s listserv about the treatment of individuals who categorically deny their sex crimes of record. Many felt it was inappropriate, even impossible, to provide treatment for a problem that the client said didn’t exist (in fact, much has been written in this area by authors such as Liam and Bill Marshall). Others asked what message treating denial would send to those who had been victimized; would we be indicating that their experiences don’t matter? How would we justify our actions to them? It was author Richard Parker who asked, rhetorically, what we would say to those who would be victimized in the future because we chose not to treat someone in denial. It was a good question, and one that reflects Dr. Parker’s deep thinking.

Richard Parker starts this book with another interesting observation. He describes a Vietnam War era pilot who stated that:

(f)lying a helicopter was much more difficult than flying a fixed wing aircraft, as the natural inclination of a plane was to fly level and straight, whereas a helicopter’s natural inclination was to flip upside down and plummet towards the ground at high speed. A helicopter pilot … could not afford to remove their hand from the control stick, as constant adjustments were required to avoid disaster.

The more I observe correctional systems, the more I become convinced they resemble helicopters, not planes.  Despite the preponderance of research about how to reduce reoffending, correctional institutions seem to be driven to ignore some, or all, of this research, like moths fly suicidally towards a flame.

Those who have spent time around such institutions are liable to agree. In this writer’s experience, there even seems to be a sort of life cycle that programs go through, of better times and worse, depending on leadership and contextual factors. From the start, Parker emphasizes the importance of implementation efforts.

The Correctional Helicopter is accessible, well written, and will interest both newcomers (particularly in its introduction of key concepts) and more seasoned professionals (especially through the appendix, which richly describes outcome evaluation). It opens with a foreword and endorsement from Paul Gendreau, one of the true giants of the correctional literature. From there, it provides an up-to-date review of the literature on “what works” in correctional treatment. Parker conducts a concise, thorough review of the principles of effective correctional practice, including the principles of risk, need, and responsivity. A particularly helpful aspect of this review is Parker’s focus on the often-misunderstood responsivity principle.

From there, Parker explores the processes by which face-to-face workers often fail to follow the principles of effective correctional practice. This includes by ignoring and undervaluing risk assessments, ignoring, the need principle, and confusion around who the client actually is. He further explores professionals’ responses to clients. As throughout this book, this chapter is carefully laid out as well as expertly conceived.

Further sections focus on management, legislation, policy, and adaptation of the principles of correctional practice. Each is helpful and covers new ground. Parker has pulled in virtually all the extent research. This writer’s only wish would be that there were more sections on precise steps practitioners and administrators can take to improve services. The book concludes with an excellent appendix on treatment outcome evaluation methodology, which includes a helpful summary of research as well as insights into topics such as treatment dropout.

This book is current, thoughtful, and concise. It reflects very considerable knowledge developed over years of practice and hard work. It is highly recommended for those entering the field as well as those seeking to deepen their knowledge and fixing their sites on how they can improve their services. As its title suggest, the work involved – with public safety and client wellbeing in the balance – is harder than it looks.

Gregg Belle, Ph.D. of Quincy, Massachusetts, USA

What year did you become an ATSA member?

I joined ATSA in September 2012, though I have been attending ATSA conferences since 2009.

Tell us about your experience in ATSA and your work with this population. Feel free to identify your accomplishments.

Having conducted Sexually Dangerous Person (SDP) evaluations and sexual offender risk assessments for over 16 years in Massachusetts, ATSA continues to be an invaluable resource.  In my varying roles as an evaluator, administrator, and educator, it is essential that I stay updated on the research and best practices in both the assessment and treatment of sexual offenders.

For almost 10 years I oversaw contracts with the Massachusetts Department of Correction (DOC) that provided a pool of Qualified Examiners (QE) to conduct SDP evaluations.  ATSA conferences and website resources have provided a wealth of opportunities to learn and understand how sex offender civil commitment evaluations are conducted in different states and countries.  I have also been able to learn from fellow administrators some of the challenges and obstacles they have faced within their respective programs.

For 9 years I have been an Adjunct Professor in Psychology at Roger Williams University in Bristol, RI.  I teach undergraduate courses in Psychopathology and have taught graduate level courses in their Master of Arts in Forensic and Legal Psychology program.  I always look forward to the first few lectures after an ATSA conference to share with my students what I learned and experienced.

What are some challenges in your work?

Establishing a practice, Forensic Insight Group, in January 2020 with my business partner and fellow ATSA member Angela Johnson, Psy.D., a few months before the COVID-19 lockdowns posed unique challenges to our practice.  It forced us to expand the types of services and consultations we provide regarding assessing and treating of sexual offenders.  

A significant challenge in my ability to conduct SDP evaluations as a Qualified Examiner is the limitations imposed by the Massachusetts DOC.  As a QE, I am only able to use psychological assessments that have been approved by the DOC.  Specifically, the only approved actuarial tool at this time is the Static-99R.  This certainly creates an unfortunate obstacle in my ability to follow best practices within these restrictive guidelines.

Tell us a little bit about yourself?

I grew up 30 miles south of Boston and continue to live in Southeastern Massachusetts.  I graduated from Brown University with a bachelor’s degree in Psychology and graduated from Washington University in St. Louis, MO with both a master’s degree and Ph.D. in Clinical Psychology.  I then completed a forensic postdoctoral fellowship through the Law and Psychiatry Program at UMass Medical School.

I met my wife in preparation for my first time ever testifying in an SDP hearing.  I was her expert witness as she was the prosecuting attorney.  When I tell people that a pedophile brought us together, it is not a joke.  Sometimes you truly cannot make this stuff up!

What are some interesting things about the area where you work and live? This is for people who may not be familiar with the area where you are from.

My practice is in Quincy, Massachusetts.  Quincy is the 7th largest city in the state.  It is also known as the "City of Presidents" because it is the birthplace of two U.S. presidents John Adams and his son John Quincy Adams.  John Hancock, the first signer of the Declaration of Independence, is also from Quincy. 

As an avid sports fan, I take great pride that over the past 10+ years, Boston is now known as the “City of Champions” with our beloved New England Patriots, Boston Red Sox, Boston Bruins, and soon-to-be champs again Boston Celtics.

Welcome ATSA's newest members

March 28, 2022

Thomas Biley, MSEd, from Duluth, MN, United States

Justin Cusumano, MA, from Melbourne, FL, United States

Ingeborg Davik, Psychologist, from Oslo, Norway

David L. Delmonico, PhD, LPC, from Pittsburgh, PA, United States

Felicia Ewing, LCPC, LSOTP, from Swansea, IL, United States

Carl Kueffer, LMSW, from Ithaca, NY, United States

Jennifer Lake, MA, LMFT, from Roseville, MN, United States

Sebastian Moad, MSW, CSW-I, from Las Vegas, NV, United States

Kristen Morse, LMSW, from Ithaca, NY, United States

Melvin Pagan, PsyD, from Winter Park, FL, United States

Jocelyn Patterson, LMHC, ATR-BC, from Arcadia, FL, United States

Shavonne Rich, MS, LMHC, from Pinellas Park, FL, United States

Chelsea Sheehan, PsyD, from Tallahassee, FL, United States

Lindsay Shoup, LMHC, from Quincy, MA, United States

April 11, 2022

Lindsay Dees, PsyD, MSCP, from Long Grove, IA, United States

Melissa DeSoto, LSW, from Greensburg, PA, United States

Emma LaPlante, from Montréal, QC, Canada

Jolene Martorano-Pagnotta, LAC, MFT, from Brighton, CO, United States

Miho Morita, PsyD, from Williamsburg, VA, United States

Melissa O'Neill-Dobosz, MS, LPC, from Media, PA, United States

Leah Robertson, PsyD, from Bridgewater, MA, United States

Lauren Schuur, LISW, from Mason City, IA, United States

Michelle Steinberger, from Ventura, CA, United States

May 6, 2022

Angie Barcenas, from La Crosse, WI, United States

Mary Belken, RN, from Farmington, MO, United States

Emily Bonawitz, MA, from Manchester, NH, United States

Amanda Fenrich, MA, from Moose Lake, MN, United States

Courtney Haviland, MSW, LGSW, from Moose Lake, MN, United States

Samantha Hinderks, LPCC, from Roseville, MN, United States

Gabriella Kenner, LMSW, from Poughkeepsie, NY, United States

Barbara Mazzarella, LCSW-R, from New York, NY, United States

Andrew McKenzie, MSW, RSW, from Toronto, ON, Canada

Alexandra Michelin, PsyD, from Salem, OR, United States

Rebecca Sue Nesler, MS, MA, NCC, PLPC, from Cape Girardeau, MO, United States

Kaitlyn Saathoff, LPC, LASOP, from Paxton, IL, United States

Suchika Siotia, MSc, from Santa Barbara, CA, United States

Tamara Smolinski, MA, from Christchurch, CAN, New Zealand

Megan Tucker, PhD, DipClinPsyc, from Christchurch, CAN, New Zealand

Ashley Wine, MA, LPC, LASOP, from Winfield, IL, United States

Shelby Winn, from Glen Carbon, IL, United States

Heleen Wittusen, from Draper, UT, United States

Gabrielle Young, MSW, LCSW, CSAYC, from Indianapolis, IN, United States

May 31, 2022

Willis “Jerry” Beasley, LAC, from Tucson, AZ, United States

Luz Celaya, RAS, from Commerce, CA, United States

Julia Fraser, from Hamilton, ON, Canada

Morgan Hand, MS, from Clifton Springs, NY, United States

Amanda Hawthorne, MSW, from Jacksonville, FL, United States

Aliya Heller, PsyD, from Albany, NY, United States

Sarah Henrichs, MA, LAC, from Phoenix, AZ, United States

Luke Malone, MA, from Lowell, MA, United States

Amy Nihart, from Minnetonka, MN, United States

Renaye Taufahema, from Christchurch, CAN, New Zealand

Natalie Tilque, MA, CMHC, from Phoenix, AZ, United States

Ashley Wentzel, MA, LMFT, from Rochester, MN, United States

Samantha White, from Minneapolis, MN, United States

Bradley Wosik, LCSW, from Sandy, UT, United States

2022 ATSA CONFERENCE: October 26 - 29
Click here!

41st Annual Research and Treatment Conference
October 26 – October 29, 2022

The Westin Bonaventure Hotel & Suites
404 S Figueroa Street
Los Angeles, CA 90071

Conference Program Co-Chairs:
Amanda Pryor, MSW, LCSW, CSAYC & Jeffrey Sandler, PhD

Registration Opens in July! ATSA Conference Registration Brochure Coming Soon!

The 41st Annual Research and Treatment Conference is the ultimate gathering for professionals at all levels of education and practice who are working towards the prevention of sexual abuse.

We are excited to bring this educational and networking opportunity to individuals across the globe on October 26 - 28, 2022 at the Westin Bonaventure Suites & Hotel in Los Angeles, California, USA.

Conference Pricing:

Early Bird Registration Rates - On Or before August 31, 2022

Wednesday, October 26 Member Non-Member
Full Day or Two Half Days $215 $255

Early Bird Registration Rates - On Or before August 31, 2022

Thursday-Saturday, October 27-29 Member Non-Member
Concurrent & Plenary Sessions $360 $500
Student Rate $125 $130
Continuing Education $45 $45

*Upon receipt of your registration we will email a link to invite you to reserve your hotel accommodations at the conference rate of $195.00, plus tax, USD (single/double occupancy).

ATSA Fellow Applications Open


Being a Fellow in ATSA is an honorary designation that was created by the ATSA Membership Committee and the Executive Board to recognize ATSA members who have demonstrated allegiance to their profession and a strong commitment to the ongoing work of the Association.  A Fellow of ATSA goes “above and beyond” in regard to their dedication and contribution to ATSA.  The ATSA Fellow designation is an enhancement to their professional credentials and is recognized by their colleagues in ATSA as a member of a select group, comprised currently of about 5% of ATSA membership.

Fellow applications require review and approval by the ATSA Membership Committee and Executive Board.  All newly appointed Fellows will be publicly recognized in the ATSA Forum and virtually at the 2022 ATSA Conference. Fellows receive a Fellow certificate that they can display with pride in their office and can use the initials ATSAF after their professional name to indicate ATSA Fellow status.

Submission Deadlines

Self-submissions or nominations from other ATSA members will be taken at any time and should be submitted to the ATSA office, but there is a deadline of September 12th to be included in this year's public recognition at the Annual Membership Meeting at the ATSA conference. To nominate a colleague for Fellow status, complete the ONLINE APPLICATION and arrange for 2 letters of reference to be emailed to

Self-submissions or nominations from other ATSA members should be submitted to the ATSA office no later than September 12, 2022.

What are the requirements to become an ATSA Fellow?

  1. Not less than seven consecutive years as an ATSA Clinical, ATSA Member or previous Clinical Associate, Research Associate. (Years spent as current Associate and Student Members, or the previous Affiliate Member, do not count toward the ATSA Fellow.)

  2. Two letters supporting your submission or nomination must be received from current members of ATSA describing your dedication and strong commitment to ATSA, and why you should become a member of this select group.  Letters should explain how the applicant rises to the level of Fellow, distinguishing them from a routine member of ATSA.  Letters should not be requested from individuals who you directly supervise.

  3. The ATSA member should be outstanding in their field and have made significant contributions to ATSA as demonstrated by completing at least four (4) requirements from the following list while a member of ATSA:
  • Involvement in ATSA by serving on an ATSA organization committee or board
  • Involvement in ATSA by serving in a local chapter leadership role or committee
  • Organization of or major participation in an organized activity of ATSA or your local chapter
  • Give a professional presentation (paper presentation, poster session, workshop or symposium) at an ATSA Annual Conference
  • Give a professional presentation at a local chapter conference
  • Publish a scientific or scholarly article in the ATSA journal (Sexual Abuse)
  • Publish a scientific or scholarly article in the ATSA Forum
  • Serve as an editor, associate editor or on the editorial board of the ATSA journal (Sexual Abuse) or have reviewed at least ten (10) submissions to the journal
  • Publish an article on sexual offense assessment, treatment or prevention in a peer reviewed professional journal other than the ATSA journal (Sexual Abuse)
  • Participate in furthering ATSA’s contribution to public policy for the prevention of sexual abuse by aiding with the creation of a legislative or court response or press release
  • Participate as a mentor to a less experienced ATSA member as part of the ATSA Mentoring Program for at least one year
  • Other major contribution to ATSA or local chapter that is approved by the membership committee

Forum Submission Guidelines

The Forum is published on a quarterly basis with editions in the spring (March), summer (June), fall (September), and winter (December) every year. We accept and encourage submissions at any time of the year, with review priority given to submissions received before the submission deadline (see below).  While submissions received and accepted before the deadline will be prioritized for the next available issue, it is at the discretion of the Forum editor and editorial board to decide which articles are included in each edition of the Forum. This is to ensure that the quality, length, and topic variability of each Forum is maintained across editions. The following include submission deadlines:

  • February 28
  • May 31
  • August 31
  • November 30

Submissions will undergo peer review, and authors will receive a response within a timely manner to indicate receipt, editorial comments, and acceptance. Accepted submissions may be published in the next or subsequent editions.

Authors should follow these guidelines when submitting to the Forum:

  • Articles should be submitted in Microsoft Word. Single spacing, 12-point font is preferred.
  • Length of articles should be between 3- and 7-pages including references for single spaced articles. Authors are highly encouraged not to exceed 7 pages. If the submission is longer than 7 pages, please include a cover letter explaining the necessity for the longer length.
  • Articles should be written in a manner appropriate for a professional newspaper or magazine. Blogs are better suited for the Sexual Abuse blog while research articles are better suited for the Sexual Abuse journal. Blogs are short and reflect the personal tone/opinion by the author. News articles like the Forum tend to be longer, include citations to support statements, and convey facts, information, and news in a professional manner. Journal articles are detailed and longer, which frequently follow a structure when describing a methodology and outcomes. Forum submissions describing research should focus on translating the study or studies into applied best practices.
    • Note that the Forum does accept Letters to the Editor, which may read like blogs, but which is a direct response to a previously published piece in the Forum.
  • There is no limitation on topics as long as it relates to the work within ATSA, and it is written in a professional manner supported by facts. Writing should be done in a manner that is inclusive of all groups of people and cultures, avoids unnecessary labeling, and uses person-first language.
  • To the extent possible, authors should follow APA publication style guidelines (7th edition), especially for citations within text, the reference section, tables, and figures. Abstracts are not needed. The inclusion of keywords is voluntary.
  • Tables and figures are published by the Forum via a screenshot of the table/figure or authors can submit a separate jpg file (no more than 200 KB) containing the table/figure. Please ensure the table/figure is APA style and picture ready. Indicate where in the text the table/figure should be inserted.
  • Articles should include a title, author(s) name(s), and professional affiliations.
  • Include a statement at the end of the article whether any of the authors have a potential conflict of interest to report (e.g., financial gain from the topic they are writing about).
  • When making submissions, please include a professional photo of the author(s) in jpg format (optional). The photo should be no more than 200 KB.

    Send submissions to

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