Does treatment for sexual offending behavior increase or decrease the likelihood of reoffending?

In most jurisdictions in the United States, a person convicted of a sex crime is mandated to treatment.  This treatment tends to be group therapy with the primary modality being Cognitive Behavior Therapy, also known as CBT.  As a community of treatment provider0,s we are always striving to improve our practices, use evidenced based treatment modalities and use the interventions best suited to our clients to help decrease their risk of recidivism.  So the question of whether or not what we are doing is helpful or harmful comes up, we need to pay attention.

The keynote address Thursday morning at this year’s ATSA conference was by Dr. Teresa Gannon.  She presented her recently published meta-analysis of the effectiveness of sexual offender treatment.  This article was recently published in Clinical Psychology Review and is open access.  The study looked at all types of violent offending but Dr. Gannon spoke this morning specifically about treatment for sexual offending.

There have been some studies that have been published that have provided a grim picture of treatment.  Most specifically, Dr. Gannon points to a 2017 report from the UK Ministry of Justice that stated that people who had committed sexual crimes and had treatment had a 25% increase in their rates of recidivism.  To those of us who do this work, that is a shocking number.  No treatment provider wants to do more harm than good and none of us would ever knowingly do anything that would increase the risk of harm to anyone. 

Enter Dr. Gannon and her colleagues.  They embarked on a meta-analysis of 70 studies on offending behavior.  Specifically they also looked at variables that could influence treatment outcomes.  Their work asked three specific questions.  1). Does offense specific treatment influence recidivism risk?   2). Is a trained psychology professional needed?  And 3). What program variables are important for success.  Again, if you want to read the full journal, you can obtain it free from the journal Clinical Psychology Review. 

The results of the meta-analysis were both encouraging and enlightening.  The results indicated that over a 6 year follow up period, those individual who engaged in sex offender specific treatment reoffended at a rate of 9.5% and those individuals who did not attend sex offender specific treatment reoffended at a rate of 14.1%.  This means that those who attended treatment were 32.6% less likely to reoffend than those individuals who did not attend treatment.  This result is the encouraging part.

The next set of results elucidated what program variables were important for reductions in recidivism.  The first important question involved the presence of a licensed psychology professional.  Was there a licensed professional involved in provision of treatment?  This was broken down into unclear/none meaning that a psychology professional was not directly involved with providing treatment or it was unclear.  The other categories were inconsistent and consistent.  The results indicated that treatment is more effective when a psychology professional is consistently hands on in the treatment process. 

The last set of factors that were investigated involved actual variables in the treatment program.  It was found that offenders who attended group only had better outcomes than those who attended group and individual therapy.  Those programs where there was supervision by a licensed psychology professional had better outcomes.  Programs that used arousal conditioning had lower recidivism rates and those programs that did not use the polygraph had better outcomes than those programs that did use polygraph testing. 

This meta-analysis posits that when providing treatment for people who have sexually offended, we need to think about several key elements shown in this study to improve outcomes and reduce recidivism.  The most effective treatment programs had the following characteristics:  A licensed psychology professional with expertise in treating sexual offenders, who is hands on and consistent in the treatment.  Inappropriate sexual interest is addressed.  It is group based and supervision by a psychology professional is provided.  The polygraph is not used in treatment. 

On a side note, the study indicated that the countries with the best outcomes for treated offenders were Canada, New Zealand and Australia. 

This is the most up to date meta-analysis of sexual offender treatment efficacy published.  It is the first to provide some evidence for the efficacy of arousal conditioning.  It also indicates that it is not just treatment that is effective but treatment provided by individuals with expertise in the field and offer supervision to treatment providers. 

Trying to Predict and Prevent Institutional Abuse

It seems as though there is another story in the news every day about the discovery of some type of sexual abuse in a church or school.  This is both a good and a bad thing.  It is good because it means that more victims are starting to come forward, speak their truth and hold their abuser accountable.  This is obviously a bad thing because people continue to be abused by those whom they trust and are in positions of power or authority. 

The more media coverage these incidents gain, the larger the public outcry.  As with any type of sexual abuse, the question becomes, how do we prevent institutional abuse?  We all want to believe that there is some way to screen out those individuals who might be prone to sexually abusing others and not allow them to be priests, clergy, boy scout leaders, teachers, etc.  Despite the prevalence of this form of abuse, there is not a lot of research on institutional sexual abuse as a specific form of abuse.

To try to combat this lack of research and work toward decreasing sexual abuse in institutions, ATSA’s most recent edition of their scientific journal, Sexual Abuse, was dedicated to the problem of sexual abuse in institutions.

I believe that it would be easier for the public to believe that there is something particular about people who abuse others in institutional settings than people who commit sex crimes outside of these settings.  In reviewing the literature on the subject, Harris and Terry (2019) indicate that CSA perpetrators who are in institutional settings possess similar characteristics to those who offend in other settings.  Additionally, the factors that make children vulnerable to abuse are not unique to these settings either.  This makes it difficult to identify those who might abuse and keep them out of situations where they have easy access to victims.

Amrom, Calkins & Fargo (2019), researchers from John Jay College of Criminal Justice in New York, looked at personality characteristics of sexual abusers in the hope of finding a way to identify sexually abusive clergy.  They used the MMPI-2 and MCMI0-III in the study, which are widely accepted personality measures.  What is known from studies of pre-employment MMPI-2s is that clergy applicants tend to present as defensive, extroverted, compulsive, self-confident, uncomfortable with expressions of anger and in possession of a strong need for approval.  Additionally, past research shows us that Episcopal and Presbyterian clergy applicants tend to present as generally well adjusted but do display elevations of narcissistic, compulsive and histrionic traits. 

Amrom et. al.’s study looked at the MMPI-2 and MCMI-III of three categories of people.  The first category was clergy who were sent to treatment for child sexual abuse.  The second category was clergy that were referred to treatment for noncriminal sexual behavior with adults and the third category was clergy that were referred to treatment for non-sexual reasons such as depression or drug or alcohol problems.  The control group was a group of clergy that took the test for pre-employment and had no history of clinical or sexual issues. 

The results of this study indicated that there were no differences between the sexual abuse group and the sexual misconduct group.  There was a difference between the sexual abuse group and the clinical group in that the clinical group showed more signs of psychopathology than the sexual abuse group.  One elevation was found on the Sexual Abuse group MCMI-III scores and that was for the trait of Aggressive/Sadistic subscale.  Ultimately, the authors opined that the MCMI-III and MMPI-2 were not able to distinguish between the Sexual Abuse group and the other three groups suggesting that these personality measures are not very helpful when it comes to screening out possible future sexual abusers from the clergy applicants.

Another study in the special edition by Spraitz and Bowen (2019) looked at the grooming techniques used by priests who have sexually abused.  Some studies into the topic have shown that, in addition to traditional grooming techniques, clergy will use their role as priests or as an extension of God as grooming technique when abusing parishioners.  The researchers analyzed records from several Archdioceses and unsealed records that all involved priests or monks in sexual abuse cases.  From these files they created a taxonomy of grooming techniques in the priest sexual abuse cases.

Grooming is the term used for the process that a person uses (normally an adult with a child victim) to create a “special” relationship with a victim and create opportunities to abuse.  In this study, priests used the following techniques:  1) giving alcohol, cigarettes or drugs to the victim, 2) giving gifts to the victim, 3) taking the victim on overnight trips, 4) physical contact, 5) using mentorship or friendship, 6) playing favorites, 7) creating a relationship with the family and 8) abusing the position of respect and reverence. 

Like other studies in this special journal edition, the researchers found that the abusive clergy in their sample were no different from non-clergy who use grooming to sexually abuse .  The technique of abusing the position as a person of God was not an overt form of grooming. They found that the use of this technique may not be “purposeful, overt, or done consciously in all instances.”  There were clergy who did use this technique overtly but not many in this study.

In short, the studies in this special issue of Sexual Abuse confirm that (for the studies published) the individuals who perpetrate sexual abuse in institutions are not significantly different from those who abuse outside of institutions.  These results are frustrating as it would be a boon to the prevention of sexual abuse if there was a way to predict who might abuse versus who might not. 

The research will continue and hopefully, in the future, more work will be published that can help prevention efforts.

Sentence Mitigation: Is it just a defense tactic or can it be a motivator for treatment?

A recent posting about our intensive program for sexual offenders on a professional social network greatly upset a person on the network.  This person felt that it was disgusting that we offer a treatment program that can aide sentence mitigation for people accused of sexual crimes, or to paraphrase, that we help sex offenders get lighter sentences for financial gain.  This upset me greatly as I take our work with people who have committed sex crimes very seriously and consider it prevention of sexual abuse.  As I consider part of my work as an expert to counter emotion with science, I thought to put my own emotions on the back burner and write something educational about sentence mitigation.

What is Sentence Mitigation?

When someone is being sentenced for a crime a judge is obligated to take into consideration all of the information about that person.  It is the job of the prosecution to present evidence of all of the aggravating factors in the case.  These are the things that help them make an argument for stronger and harsher sentences.  Aggravating factors can include prior offenses, vulnerable victims, hate crimes, violence, etc.

It is the job of a defense attorney to present the facts about the person that would support a less harsh sentence.  Any facts presented for sentence mitigation are not related to the guilt of the person, they have acknowledged what they have done (pled guilty). Mitigating factors can be those that were in place prior to the offending such as lack of criminal record, mental illness, addiction, physical illness, history of being abused.  Other mitigating factors are those the occur after the offense has happened.  These can be acceptance of responsibility, rehabilitation post offense (treatment), cooperation with law enforcement, addiction, mental illness, etc.  Mitigating factors do NOT excuse a crime but help provide an explanation. 

Therapy as a Sentence Mitigation Tool

Do defense attorneys suggest clients go to therapy so they have some fuel for sentence mitigation?  In a word, Yes. Many of our clients are referred to us by their attorneys after they have had a visit from the police or the FBI.  This happens basically no matter the type of offense.  DUI?  Get a drug and alcohol assessment.  Domestic Violence charge?  Do some classes.  Assault charge?  Complete an anger management program. 

What most people might not know, but all of us in the treatment community do know, is that very few people self-refer for treatment relating to addictions of any kind or offending.  In over 10 years of practice ownership, I can count on one hand the number of clients who came to treatment with no outside pressure because they felt like they had a problem.  Many clients are pressured into treatment.  This pressure may come from a partner, spouse, employer or the police.  People don’t self-refer for many reasons, shame, fear, stigma and wait until they are caught in some way shape or form be that watching pornography at work, getting a DUI, getting caught in an affair, running up the credit cards with gambling debt, etc. 

The act of going to therapy itself does not help the defense attorney make a mitigation argument.  It is what happens in therapy that can help a defense attorney make a mitigation argument.  If a client is referred by an attorney for treatment, the initial thought might be something like “ok this will look good to the judge.”  Any good therapist will know whether or not a client is taking the therapy work seriously.  If the client is just biding time, trying to look good for a judge, that is reflected in the treatment reports that go to the attorney.  Trust me that bad treatment reports never make it to court.  Same thing for evaluations that deem a client high risk to re-offend.  They hardly ever see the light of day in a court room.

Changing motivations

What gets a person in the door of a therapy office is not necessarily what keeps them there.  The goal with pre-sentence treatment is to help the person move from the “oh shit I’m caught” stage into really deeply and truly looking at their actions and the motivations for the actions.  Though it is popular to believe that people who commit sexual crimes are deviant monsters who deserve to die, most (not all) people who are committing these crimes know they have a problem, feel a good deal of remorse and want to do what they can to help themselves.  Thus, an attorney referral to help with sentence mitigation can turn into a person who really wants to do a lot of work on themselves to get better and make sure they never offend again. 

Sitting at the end of a day filled with many emotions, I reflect on the work I do.  I am proud of the work that I and my staff do working with people who have committed sexual offenses.  I realize that I work with a population of people that the world would rather forget about and many people think don’t deserve treatment.  Though it would be great if more people self-referred, I ultimately don’t care if it is an attorney referral that gets them through the door.  Those of us who work with sexual offenders are doing prevention work. 

My final words are not mine but those of one of my wonderful colleagues:  Everyone deserves treatment.  Period. Full Stop. 

References

https://www.nolo.com/legal-encyclopedia/mitigating-circumstances-sentencing.html

https://www.justia.com/criminal/aggravating-mitigating-factors/

https://www.criminaldefensemitigation.com/mitigating-factors-criminal-sentencing/

What BDSM Can Teach Us About Consent

Let's Talk: Consent | Her Campus

Consent is a hot button topic today.  The #metoo movement continues to grow and the supreme court nomination brought to light the suffering of many sexual abuse survivors.  The general public is starting to realize that we do not teach consent to our children

Those of us who work in the fields of sexuality (sex therapists, sex offender therapists, sex addiction therapists) have long known that there is a lack of education about consent.  We have moved from no means no to yes means yes but that still leaves a lot of grey area.  For instance, what happens when yes turns into no?

To help learn more about consent, I turn to what some might think is a strange source, the Kink community.  The BDSM community has a lot to teach the rest of us about the concept of consent.

While there are many aspects of the BDSM world, consent lies at the heart of these communities.  Here’s how:

Negotiation:

Critical to the BDSM community is negotiation.  People who are going to play (engage in BDSM) together spend a great deal of time ahead of time negotiating what will happen during the session.  These discussions about the sex practices that will or will not be engaged in during the session are often extensive.  Negotiations include what each participant’s limits are (what they will not engage in), what types of things they enjoy as well as the discussion of the safe word.

When two people engage in extensive negotiations before an interaction it removes the grey areas that can happen when there is not good communication.  There is no room for miscommunication because it has all been talked about ahead of time.

Safe Word:

The safe word is the word that is agreed upon ahead of time which, when invoked, means the behavior that is currently happening ends immediately.  This process of safe word shows that the BDSM community understands that consent is not a broad concept.  Consent is an ongoing process that can be revoked at any time during an interaction. Just because someone says yes to something initially, it does not mean theywant the behavior to continue.  Everyone’s experience of a sexual behavior is dependent on so many things.  What they might have enjoyed engaging in during one session may not feel good in another based on many things, not limited to mood, stress level, partner and environment.

Aftercare:

Aftercare is a concept that is not often talked about in traditional sexual encounters.  The BDSM community understands that these interactions can be emotionally and physically intense.  Aftercare takes this into consideration and involves physical and emotional support for the parties involved.  This can be physical, meaning food, water, etc. or emotional, such as cuddling, holding, stroking etc.  When both parties engage in aftercare it demonstrates a mutuality in the interaction.

Traditional sexual interactions among the non-Kink community normally do not involve any of these processes.  Traditionally, there is very little discussion about what behaviors are ok between two sexual partners.  Safe words are hardly ever employed and frequently, in our hook up culture, the after-sex behavior lacks emotional and physical nurturance.

I will end this post with a quote I heard at this years ATSA conference.  “We spend more time negotiating what we want on a pizza than we do negotiating sex.”

We have a lot to learn from the Kink community and if we employed some of their practices into our own sexual practices we would be having safer and more truly consensual sex.

Reference:  “Unorthodox Rules”:  The Instructive Potential of BDSM for Consent Law.  Bennett, T (2018) Journal of Positive Sexuality, 4(1), 4-11.

 

Dr. Jennifer Weeks is the owner and director of Sexual Addiction Treatment Services.  She is a clinician and expert witness working with sexual abuse, cybersex offenders and all types of problematic sexual behavior.

You’re Being Investigated for a Cybersex Crime: Now What?

 

gavel and handcuffs on laptop

If you are reading this blog, either you or someone you care about has recently been visited by the police and are under investigation for a cybersex crime.  You are likely in shock and are likely panicking.  After many years of working with people in this situation, I have learned a thing or two of what to do next.  Even though you might be panicked, immobilized, in shock or depressed, you must take action.

Here is what you need to do right away.

  1. Hire an attorney

If you have the money or can rustle up the money, you need to immediately hire an attorney.  I will talk about what to look for in an attorney in a later post.  What you need to know in these first moments is that you should not just hire the first attorney you talk to.  Talk to several criminal defense attorneys.  Find out how much experience they have working with cybersex cases.  Make sure that the attorney has experience working with cybersex cases at your level.  If the FBI is investigating you, you need an attorney who has experience in Federal Court.  If you cannot afford to hire an attorney, you are going to have to be your own advocate during this process.  A court appointed attorney won’t have the time to give you what a private attorney will.  You will have to do some of the leg work yourself.

  1. Make sure you are safe

When I say make sure you are safe, I mean make sure you are emotionally safe.  People who are investigated for cybersex crimes frequently feel immediately suicidal.  The majority of cybersex offenders have never been in trouble with the law before and the entire process can cause a shame spiral.  If you feel suicidal, go to the emergency room or find a hospital where you can go for a few days to ensure your emotional health and well-being.  If you are the loved one of someone who is under investigation be aware that they may be experiencing suicidal thoughts.

  1. Find a therapist

Now is not the time to just go down the list of in-network treatment providers from your insurance.  You don’t just need a therapist, you need a specialist.  The therapist you see should have experience treating people in your exact situation. They should have experience treating sexual offenders and perhaps pornography addicts.  While many therapists might be able to help you work through the anxiety and depression that will occur related to the investigation, if they don’t have experience working with the specific sexual behaviors or the court process, they will not be as effective as someone who specializes.

The criminal justice system works at a rather slow pace.  You will have time to deal with all of what comes after the investigation.  I will address many of these things in further posts.

If you are newly investigated please do things now and start to let experienced professionals help you through this process.

 

Dr. Jennifer Weeks is a Clinically Certified Sex Offender Treatment Specialist and an expert witness in the areas of sexual offending, cybersex offending and sexual addiction.  For more information on her services please go to the Sexual Addiction Treatment Services website. 

 

 

What Young Women’s Experiences with Sexting can tell us about Compliance, Coercion and Consent

The #MeToo movement has brought much needed attention to the experiences of women, of any age, of sexual abuse and harassment.  If you look behind the sensational headlines, the movement has sparked a much-needed conversation about consent.  I have previously written about how we teach consent in our practice in a blog on the topic.  The #METOO movement combined with some recent research published in the Sexuality Research and Social Policy journal can help us shed some light on how young women navigate sexuality and consent in the digital realm.

Dr. Sara Thomas recently published a research study in the journal of Sexuality Research and Social Policy that looked at how young women handled pressure to send them a nude or semi-nude photograph from a peer.  Dr. Thomas’ study analyzed stories from teenagers about their experiences of digital drama.  She then identified three main dilemmas that young women experience in relation to sexual photographs.  These were interpersonal negotiations, consequences and self-concept.  She then identified six different categories of behavior for how women were induced to send nude photographs.  These were desire, personal gain, asked, relational scripts, bombardment and coercion.

One of the first dilemmas faced by a young woman is the decision of whether to send a photograph.  The study found that 2/3 of young women reported that they engaged in this ongoing struggle to decide if they should send a picture, if so to whom and when should they do this.  When a woman decided to send a nude photograph, the motivations ranged from it being consensual to giving in to pressure or threats from the person asking for the picture.

The young women in this study knew that if they chose to send a nude picture there could be consequences.  These consequences ranged from the picture being seen by people they did not want to see (mass distribution) to social ostracism, rumor spreading, legal consequences, emotional distress and getting in trouble with parents.  The study found that the biggest concern was the possibility of the image being spread without consent.

Why do young women send nude or sexual photographs?  In this study, only 8% of the young women sent the photograph because they wanted to.  If they didn’t want to send the image, why did they?

Compliance:  The study found that many young women were sending nude images because they wanted to please the person asking for the image or because they wanted to avoid negative consequences from the young men that were asking for the images.  One of the troubling findings from the study was the tacit nature of the compliance by the young girls.  The young women justified the compliance by saying that they liked the young man who was asking for the image.

“..compliance was frequently accompanied by an assertion they liked the young man who requested them.  These stories did not express coercion by the asker, but they also did not express a desire to send them.  Rather the decision to send was a compliant “so I did” to a male-initiated request for a photograph.”

Coercion:  The majority of the women in the study experienced some form of coercion.  The level of this coercion ranged from milder “If you loved me” statements from the young man requesting the image to more intense forms coercion.  When a woman was unsure of sending an image, they reported feeling guilty that their partner questioned their love by not sending a nude image.

Many of the women had experiences of coercion that were more intense.  The study found that some young men pressured, threatened, got angry or cut off contact with the young woman in order to try to obtain nude images.  The women also experienced threats of blackmail.  Some of these women were blackmailed into sending more images after they sent a first image.  The blackmail threat was often that the images would be mass distributed.  The young women who experienced these situations didn’t feel like they had any options and that they had to send the images.

Can young women refuse?  The answer to this is yes.  In the study about 30% of the women refused to send a sexual image.  Of those 30%, 79% of those women faced consequences for not sending images.  Partners would get angry.  Relationships would end.  Based on the consequences, several of the young women reported they ended up sending images to the young man who requested them.  Only 12 women in this study refused to send nude images and did not experience any negative consequences for holding their boundary.

What does this study show us?  In this study, 25 of 314 young women engaged in sexting with a partner because they truly wanted to, and the experiences were devoid of compliance or coercion.  This means that most of these young women engaged in sexting that was truly without consent.  Their behavior was induced by compliance or coercion.

We, as parents, teachers, educators, need to do a better job at many things.  First, we need to teach all young people the true meaning of consent.  We need to empower young women to say “no” to coercion and to feel strong enough to not feel the need to comply to an unwanted request.  We need to give young women access to resources to help them make decisions about their sexuality.

The young women in this study did not seek adult help but turned to peers for advice.  They often cited fearing an adults’ response as why they didn’t talk to parents or another adult in their life.  As adults, we also need to create an environment where our children feel safe to come to us with their challenging dilemmas and we need to react calmly and lovingly.

Thomas, Sara.  (2017) “What do I do?”:  Young Women’s Reported Dilemmas with Nude Photographs.  Sexuality Research and Social Policy.

For more information on Dr. Weeks please check out our website www.sexualaddictiontreatmentservices.com

 

Pedophile: What’s in a Label?

The news is awash with reports of famous men, actors, directors, and politicians whose victims are coming forward to report the sexual abuse and sexual harassment they have been subject to at the hands of these people. I applaud the bravery of each and every victim who has come forward to share their painful story. It takes an immense amount of courage to break through years of shame and silence to confront one’s abuser. Bravo. I am glad that these men and women’s voices are being heard and hopefully they can find some sort of justice or closure.

My writing today is not for those brave men and women but for the media. As someone works with sex offenders every day I have a pet peeve. That pet peeve, which sometimes gets me in hot water in facebook posts, is the fact that people throw around the word pedophile every time someone is found to have abused a minor. Besides frequently being inaccurate, it sends a message that pedophiles are the only people who abuse children. It generates fear. If we are truly going to protect children from sexual abuse by adults, we need to spread accurate information and create effective prevention plans.

So, let’s talk about attraction. When we specifically are looking at age, attraction is clinically categorized three ways.

Pedophile: A person who is attracted to PRE-PUBSECENT children. Doesn’t matter the gender of the child. The attraction is to the lack of sexual development.

Hebephile: A person who is attracted to pubescent children. Again, gender does not matter. The attraction is to a child who is in early adolescence and has signs of sexual development.

Teleiophile: A person who is attracted to adults. This attraction is to fully sexually developed adults.

A person does not have to fit into just one category. There are people who are what we call fixed pedophiles. This means they are only attracted to pre-pubescent children. Other people are attracted to several categories of sexual development. I work with many men who are attracted to pre-pubescent children, pubescent minors AND adults. They do not have a fixed attraction but find all ages of people to be sexually arousing.

The next piece of this puzzle is that ATTRACTION DOES NOT EQUAL ACTION. Many people who have a pedophilic or hebephilic attraction do not ever have any sexual contact with minors. They live with this attraction but have the awareness to know that they cannot act on these urges and they can inhibit any behavior toward minors to whom they may be attracted. In the clinical world, we call these folks non-offending pedophiles.

In Germany, there is a great program called Project Dunkelfeld that offers free treatment to any person who identifies as attracted to minors to help ensure they do not act on those attractions. This project runs ads on buses or billboards and runs public service announcements on television. These folks are getting prevention right.

The next piece of the abuse puzzle is that people offend against children for many reasons, only one of which may be sexual attraction. There are many, many reasons why adults sexually abuse children. There are too many to go into here (future post on this topic forthcoming). Only one of the reasons a person sexually abuses a child is attraction. I have worked with many contact sexual offenders against children who were not sexually aroused to children. This may make no sense at all to someone who doesn’t work in this field, but it is true. Why else might someone abuse a child? Power, control, emotional identification with children, using a child as replacement spouse (frequently seen in incest), and/or antisociality to name a few.

As I am sitting here writing this, I am trying to determine why the misuse of the term pedophile pokes my buttons. I think that if we throw around the term pedophile to label anyone who sexually abuses a child we can put them in a metaphorical box. It makes it easy to put abusers into a category and then not think about it as much. We can think, “oh watch out for pedophiles, they abuse children”. Even if it were true, how do you identify one? They look just like you and me and act just like you and me. There is no way to know someone’s sexual preference by looking at them. Labeling gives people a false sense of security that children are abused by people in this category and not by anyone else.

If we put child molesters in this lump category we diminish the complexity of the issue. It is not just about attraction to minors. The people perpetrating the abuse most often are not “the others.” They are most frequently family members or close friends of the family of the children. They are frequently people in positions of power who have the trust of the child and the child’s parents. Abusers are, most often, people that know you and your child. (the exception here being cyber cases).

If we are going to truly protect children from sexual abuse, we need to make sure that everyone has accurate information. Creating a fear reaction to a clinical label does nothing to enhance child safety. What can you do to enhance your child’s safety? Learn the truth about the perpetrators of sexual abuse. Create an open and safe relationship with your child so that you can talk to them about sex, sexuality, sexual boundaries. Learn what grooming is and help them to identify behaviors that make them feel uncomfortable, so they can come to you immediately. Arm yourself with knowledge, not fear.

Dr. Jennifer Weeks is the owner and director of SATS, an out-patient program that treats sexual offenders, problematic sexual behavior and trauma.

Her book The New Age of Sex Education:  How to talk to your teen about pornography and cybersex in the digital age is available on amazon.

Parents – Get Your Kids off Adult Dating Apps

grindr.PNG

I started engaging in prevention and education work as a direct result of my experiences working as a forensic psychologist in the field of sexual addiction and sexual offending. Despite my efforts and the efforts of many others more well-known than myself, we continue to see an increase in cybersex issues with teens.

This month, I have had several new forensic cases involving teens and dating apps. These new cases involved adult men who were found to be having sexual contact with minors that were met via the adult dating app Grindr.

First, let’s talk about dating apps. The most well-known adult dating apps are Tinder and Grindr. Tinder is used more for those who are attracted to the opposite sex and Grindr is targeted at the gay male audience. Other names you need to know: Jack’d, Scruff, Adam 4 Adam, Growlr, Plenty of Fish, Ok Cupid.

Why do you need to know about these apps? Because under age teens are on these apps, using them and meeting with adults for sexual encounter. Any and all of these apps are for people over the age of 18. They specifically state in their information that you cannot be under 18 (or 21 in some places) and use the app. The apps are for adults. The problem is that often all you must do is enter a birthdate or check a box that affirms you are at least 18 years of age and there is no age verification. Anyone under the age of 18 can do the math and figure out what birth year they need to enter to comply. If someone mutually swipes and connects with your child, they will text or chat to see if they are compatible and arrange a hook up or meeting. Sometimes, during these chats, the child may disclose that they are under the age of 18. Many times, they do not.

There are two ways your child could end up having sex with an adult via an adult dating app:

  1. They could be targeted by an adult who is specifically seeking a young or young-looking man or woman on the app. However, there is an assumption that all on the app are of legal age. During the chat, the child could disclose that they are underage. Obviously, at this point, the right thing for anyone to do is to discontinue the conversation with the minor and NOT meet them, connect with them and surely not have sex with them. However, some people will ignore what is right and hook up with the minor for sex. In this case, the person meeting the minor has full knowledge that they are underage when they are hooking up with them and knows this is illegal.

  1. A child could go on an adult dating app and create a profile that says they are at least 18 years old. They could engage with men or women on line and meet up with them for sexual encounters. The child could never disclose that they are a minor to the person they are meeting for sex. Therefore, the person who is meeting them for sex is under the assumption that they are at least 18 and they are not knowingly having sex with a minor.

What can you do if you are a parent?

  1. Talk to your child. Talk to them about dating apps, hook up apps and any social networking apps. Ask what they use and how they use it. Ask if they are on the sites. Discuss with them the inappropriateness of being a minor and being on an adult dating site. I have had clients tell me they were on these apps when they were as young as 13 years old.

  1. If necessary, block your child’s access to these sites. I am not usually a fan of blocking sites completely, but in these cases, where there are such serious risks, I say, block your child’s access until they are the legal age to use the apps.

  1. Be open to your child’s curiosity about sex and sexuality. Many of these issues occur on same sex dating sites. This is likely because adolescent men are exploring their sexuality and may not be out, feel safe doing so in their school or social network and/or have no one to talk to about their questions and feelings. Be that safe person for your child to talk to and help them find appropriate resources to answer their questions.

What can you do if you use a dating site?

  1. If you find out someone you are talking to is under 18, stop talking to them IMMEDIATELY. Report their use of the app to the administrators of the app per the app’s instructions. DO NOT MEET THE UNDERAGE USER.

  1. If you think someone is younger than 18, ask for some form of ID to verify their age. Ask for a driver’s license. Yes, someone can get a fake ID If they are underage, but you need to do this to protect yourself and not make a life altering bad decision.

Does the app bear any responsibility when a minor is preyed upon in an adult dating app or ends up having sexual encounters with an adult? The answer to this is, NO. They do not. This has been challenged in court and the apps have won, meaning that the stated age requirements and acknowledgment of the user of the rules removes them from any liability in these cases. I would urge the makers of these apps to do more to try to remove under age users from their platforms.

As always, the key to prevention is awareness and communication. Talk to your child!

For more information on Dr. Weeks please see our company website. You can find The New Age of Sex Education: How to talk to your teen about cybersex and pornography in the digital age on amazon.

Something’s Missing in the Current Drug Prevention Rhetoric

prevention

I have been an addiction therapist for approximately thirteen years.  While for some professions that may not seem like a long time, for a substance abuse professional, thirteen years in the trenches is a very long time. It is thirteen years of being underpaid, overworked, and underfunded.  It is also thirteen years of working with lost and often traumatized souls who may never ever get better.  Thirteen years as a substance abuse professional can make you weary.  However, you don’t end up in this profession and last for any length of time unless it is a calling.

Unless you are completely cut off from the outside world, you have seen many a news article lately about what is being called the heroin or opiate epidemic.  The apparent meteoric rise of addiction problems due to a prescription pill problem that for many turns into a heroin problem.  In March of 2016, the Centers for Disease Control issued new guidelines for doctors who prescribe opioids for chronic pain.  In 2015, hydrocodone combination products were moved to a Schedule II drug classification, indicating their highly addictive potential.  These changes were made in the hope of curbing the opiate addiction problem in our country, but with little effect.

This blog is not meant to be a discussion of anything related to why the situation continues to decline or what to do about it now.  What I want to talk about is prevention.  Most resources, even good resources like www.PASTOP.org, spend most of their page space talking about prescribing, what to do with unused medication, overdose and treatment information.  While all of this is very useful information, it is what I would call secondary prevention.  This is prevention of use by teens or adults, frequently who are prescribed medication initially by a doctor for a legitimate medical issue.  What is missing from the big picture of this prevention discussion is childhood.

Earlier this year, I finished reading both Dr. Gabor Mate’s, In the Realm of Hungry Ghosts and Dr. Bessel van der Kolk’s, The Body Keeps the Score.  Both are must reads for anyone who works in the addiction field.  I would like to share with you the line from In the Realm of Hungry Ghosts that inspired me to write the post.

“The prevention of substance abuse needs to begin in the crib – and even before then, in the social recognition that nothing is more important for the future of our culture than the way children develop.” P. 443

What is missing in almost all current talk about prevention is that, unfortunately, for all the people already addicted or prone to addiction, it is potentially too late.  Why do people become addicts?  Trust me in that no one wants to be an addict when they grow up or enjoys addiction.  Maybe, in the beginning, they liked the effect of the drug, but that quickly wears off.  What many addicts like is the escape.  The ability to take a substance that makes them not feel feelings they don’t like or can’t handle.  They like the fact that when they are taking the substance, they don’t have to sit in reality.  They like that the drug makes their flashbacks go away.  They like the fact that many drugs make them forget for a period of time.

In 13 years, I have yet to meet a drug addict who, at some point in their life, and most likely in childhood, did not suffer from at least one form of abuse or neglect.  Many drug addicts and alcoholics (gamblers and sex addicts too) endured verbal, physical and/or sexual abuse by their parents or family members growing up.  Many endured neglect in childhood as well, whether that was physical or emotional.  Many addicts were bullied in school and had no one safe at home to talk to about their experiences.  These childhood experiences mean that often, they looked for ways to self soothe, ways to cope or ways to feel better even if it was for a short period of time.

The ACE studies (Adverse Childhood Experiences) have shown scientific proof of what addiction counselors have known for years.  The more ACE events in a person’s life, the more likely they are to not only have physical issues but also mental health issues.  People with higher ACE scores are 2 to 4 times more likely to use alcohol or other drugs and to do so at an earlier age.  If a person’s ACE score is 5 or higher, they are 7 to 10 times more likely to use illegal drugs, report addiction or to inject illegal drugs.

So what do we do?  Addiction prevention starts before a child is born.  The in-utero environment of a child affects their neurobiological reaction to stress as an adult.  To stop drug addiction, we need to stop child abuse.  How do we do this?  Obviously, this is a tall order.  Make parenting classes more accessible to all expecting men and women.  Teach not only about physical care of a child but their mental health care as well.  Talk about attunement to a child and how that affects his or her ability to regulate emotion later in life.  Work to create safe spaces in a home and healthy attachment.  Teach communication skills from the start.  Teach healthy coping skills to even very young children.  Teach healthy coping skills to the adults so that they can model these for their children.  Work as hard as we can to prevent physical, sexual and emotional abuse of everyone.

I realize that my goals are idealistic.  I have always said that if the world gets healthy, I would happily change professions.

We need to start addiction prevention from the beginning by having discussions about childhood abuse, neglect and trauma.  We need to work to take away the stigma of therapy and getting help for emotional problems.  We need to teach everyone how to effectively communicate and cope.

I know that this is a tall order and that many do not have the resources to learn all these skills.  We need to work to provide these resources to everyone.  As a society, we need to do more……….

 

For more information on Dr. Weeks please go to our company website www.sexualaddictiontreatmentservices.com.

Photo credit.  The Watsons, NYC, NY.

We Are Failing Male Sexual Abuse Survivors

I specialize in working with sexual addiction and problematic sexual behavior. Most of my clients are men.  Working with male addicts for over a dozen years has taught me, in person, that many more boys are sexually abused than the numbers tell us.  These boys do not tell anyone and do not seek help.  These boys turn into men who are profoundly affected by their sexual abuse experiences as children and most of the time, don’t even know it.  They do not name what happened to them as abuse, or they don’t want to.  They feel so much shame about being abused that they lock part of themselves away so tightly it can take years (like 5 to 7 years) of therapy before they even acknowledge to a trusted therapist what happened to them.  These men who were abused as boys suffer in silence.

I realize that many people (myself included) will respond to this by saying that many girls and women do not disclose their sexual abuse and that they too live lives that are deeply affected by their abuse histories.  Having spent time working in a Women’s Trauma and Addiction PHP and IOP program, I do not dispute this.  However, I see a difference.

When women finally find the courage to come forward to seek treatment for their sexual abuse, they can find resources.  There are many group, individual and support resources for women who are survivors of sexual abuse.  Finding help is not so easy for men.  I will share an example from my practice to explain.

I have a male client who came to me last year who I will call Tom.  Tom has a pornography addiction and came to treatment after the problem began to cause a great deal of disruption in his life.  He had never gone to therapy and near the beginning of our work together, he disclosed that, when he was a boy, he was sexually abused by a neighbor boy who was near his age.  He had never shared this with anyone in his life and as soon as he acknowledged the abuse, the floodgates opened.  He started to have flashbacks and other PTSD symptoms.  Tom is a take charge kind of guy and we nearly immediately started to look for resources for him to do trauma work outside of our individual sessions.

First, we looked for men’s specific groups.  There was nothing and we are directly outside of a major east coast city.  Then we looked for trauma groups.  Tom talked to a few places that had groups for trauma survivors and was told that, as a man, he would make the women in the group uncomfortable so they could not have him join the group.  He then had an intake with a county resource for group trauma work.  After his intake, they told him that his case was too complicated and he could not join the group.  After months of looking, we literally could not find a group for sexual trauma survivors that was either all men or that would allow men into the group.

Tom continues his trauma work in individual therapy but craves the connection and understanding that one gets in group work.  He wants to know he is not alone and the therapeutic community was unable to tell him that, as a man, he is not alone.

Tom is just one example of many that I could pull from my case load.  To me, he is the loudest example of how we, as a treatment community, fail male survivors of sexual assault.  I have had other clients walk out of public events for sexual abuse survivors because, as the only man in attendance, they felt unwelcome and uncomfortable.

Why do we treatment professionals who work so closely with trauma not offer more resources to men? Are we uncomfortable?  Is there a reason we focus more closely on female survivors of sexual abuse?  These are questions to which I have no answers.  I have only heartbreak.  I can only do my part to welcome male sexual abuse survivors into therapy when they come and to start group programming for them in my practice.

I challenge other treatment professionals to process this issue and see what we can do to create more resources for men and to be more welcoming.

 

For a good online resource for male survivors of sexual abuse, please see www.1in6.org