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Preventative Services for Sexual Offenders
Abstract
The role of primary prevention of sexual offences is an understudied area. The current study examined a sample (N = 100) of men charged or convicted of a sexual offence to determine their interest in interventions that could be offered prior to offending, reasons for not seeking out interventions in the past, and demographic information including onset of deviant sexual fantasy and interests. The majority indicated that preventative interventions, including individual and group treatment, would have been beneficial, but inaccessibility of interventions and fear of arrest prevented them from seeking services. The findings suggest that men who progress to committing a sexual offence are interested in preventative interventions but require information regarding availability of accessible support and the development of primary prevention structures to fulfill society’s desire to prevent sexual offending.
... Det är också oklart vilka erfarenheter sexualbrottsdömda har av tidiga hjälpinsatser och vilka eventuella hinder eller möjligheter som finns i processen att söka hjälp. Forskning tyder på att skam och stigma utgör betydande hinder för den som överväger att söka förebyggande hjälp för problem som kan leda till utövande av sexuellt våld (Levenson et al., 2017;Piché et al., 2018). Om personen redan har begått ett sexualbrott som inte anmälts till polisen kan saken bli ännu mer komplicerad eftersom erkännandet kan utgöra ett påtagligt hot mot individens självkänsla (W. ...
... För personer som begår sexualbrott är det också vanligt med förekomst av depression, ångest och självmordsförsök (Jeglic et al., 2013;Maruna & Mann, 2006). Rädsla för rättsliga och sociala konsekvenser, som att förlora jobbet, hemmet, familjen och vännerna utgör ytterligare hinder för att söka hjälp (Levenson et al., 2017;Piché et al., 2018). Att utforska sexualbrottsdömda personers erfarenheter av och tillvägagångssätt för att söka stöd och behandling i ett tidigt skede kan bidra till kunskap som är relevant för yrkesverksamma att förstå hur de kan ge stöd. ...
... Med undantag för enstaka studier saknas det forskning, särskilt kvalitativ sådan, på individer som är dömda för sexualbrott. Två nordamerikanska enkätstudier visade att få av de sexualbrottsdömda personerna sökte hjälp före brottet, ofta på grund av skam och stigma (Levenson et al., 2017;Piché et al., 2018). I en brittisk kvalitativ studie (Swaby & Lievesley, 2023) beskrivs inre konflikter relaterade till skam, stigma och rädsla som hinder för att söka hjälp. ...
This Research and Development report is published by the Swedish Prison and Probation Service and contains the findings from my doctoral thesis in Swedish and with focus on relevance for the correctional system.
... Little is known about their experience from such helpseeking efforts and the barriers or facilitators involved. Existing empirical findings indicate that help-seeking for problems related to sexual offending entails substantial barriers related to shame and stigma (Levenson et al., 2017;Piché et al., 2018). If the individual has already committed an offence not yet reported to the police, this task arguably becomes even more complicated. ...
... L. , potentially causing depression, anxiety (Maruna & Mann, 2006), and even suicide attempts, which are overrepresented in the ISO population (Jeglic et al., 2013). Fear of legal and social consequences, such as losing one's job, home, family, and friends, constitute further obstacles to embracing preventive measures (Levenson et al., 2017;Piché et al., 2018). ...
... It may be difficult for many individuals to identify with such labels. Arguably, this makes them less prone to seek help from preventative services (Levenson et al., 2017;Piché et al., 2018). As Willis (2018, p. 727) asks: 'why call someone by what we don't want them to be?' Instead of 'sexual offender', in line with the terminology in the 2021 recommendations from the Council of Europe (McCartan, 2022), a person-first term is employed in this thesis: individual convicted of a sexual offence (ISO). ...
Social work plays a crucial role in the prevention of sexual abuse. Such prevention can involve protection for potential victims but also measures directed at those who perpetrate sexual abuse. However, research on desistance among those who have committed sexual offences, their treatment readiness, and help-seeking prior to conviction is scarce.
This doctoral thesis aims to explore support and treatment from the perspective of adult men convicted of sexual offences in Sweden. What are their experiences of change after participation in sex offender treatment, and how do they engage in risk-reducing interventions? Particular attention is placed on the roles of relatives and society.
Data consist of pre- and post-tests (n = 99) and in-depth interviews with men convicted of sexual crimes (n = 19). The interviews were carried out with both participants (n = 13) and non-participants (n = 6) in sex offender treatment.
Participants’ self-reports (n ~ 26) and therapist ratings (n = 46) analysed in paper I suggest that participation in the sex offender programme called SEIF may be associated with changes in criminogenic needs, potentially reducing issues linked to recidivism. However, caution is advised due to methodological limitations. Further studies are needed to determine effectiveness. According to paper II, interviewees who participated in SEIF (n = 13) appeared to have started building new prosocial narrative identities, indicative of early desistance.
The findings in paper III suggest that non-rehabilitative, punitive elements within correctional systems can create barriers to readiness. Nevertheless, supportive and non-punitive responses from staff, close ones, or fellow inmates seemed to counteract these negative loops. This hypothesised relational mechanism, promoting readiness, is termed looping disruption. Paper IV examines help-seeking behaviours and indicates that prevention efforts can either succeed or fail at various societal levels. Barriers to seeking help include a lack of awareness of the problem, fear of social consequences, and a neglectful welfare system. Professionals with specific knowledge and focus were seen as providing meaningful support, while the involvement of loved ones was a central motivator.
In conclusion, a non-judgmental, person-centred, and supportive approach is recommended, as it seems to increase willingness to change. Professionals may need specific training to tackle the challenges associated with this task. Furthermore, the thesis highlights how the significant stigma associated with sexual offences is a major obstacle when reintegrating individuals convicted of such crimes into society.
... Diese geringen Basisraten machen es aus statistischen Gründen schwierig, tertiäre Präventionsprogramme zu evaluieren und zu optimieren. 46 Andererseits werden bis zu 95% aller sexuellen Kindesmissbrauchstaten von Ersttäter(inn)en begangen (Sandler, Freeman & Socia, 2008) und es konnte gezeigt werden, dass sich männliche Sexualstraftäter im Durchschnitt etwa fünf bis zehn Jahre bemühten, ihren paraphilen sexuellen Fantasien und Impulsen zu widerstehen, bevor sie ein Sexualdelikt begingen (Piché, Mathesius, Lussier & Schweighofer, 2018). Diese Befunde legen nahe, dass es sinnvoll sein könnte, die Prävention von Sexualstraftaten auf den sekundärpräventiven Bereich auszuweiten. ...
... Die am häufigsten genannten sexuellen Probleme (rund die Hälfte der Befragten MAPs) betreffen den Bereich sexueller Selbstregulation wie speziell sexuelle Präokkupation (d.h. übermässige gedankliche Beschäftigung mit Sexualität), die Nutzung von Sexualität zur Bewältigung negativer Gefühlszustände und einen aus ihrer Sicht zu ausgeprägten Konsum von Pornografie, wohingegen nur etwa 20% speziell die auf Minderjährige ausgerichteten Aspekte ihrer Sexualität als Problem berichteten (Piché et al., 2018). Eine Mehrzahl der befragten Personen in einer Studie von Houtepen, Sijtsema und Bogaerts (2016) ...
... Entsprechend berichteten zwar 75% der befragten MAPs bei Levenson und Grady (2018), dass sie professionelle Hilfe nachgesucht hätten, aber nur die Hälfte von ihnen erlebte diese als hilfreich. Von den in einer Studie von Piché et al. (2018) befragten MAPs gab nur rund jede fünfte Person an, vorher Hilfe aufgrund sexueller Probleme nachgesucht zu haben, wobei die am häufigsten genannten Gründe für die Nichtinanspruchnahme Scham, Schüchternheit und fehlendes Wissen über Therapiemöglichkeiten waren. ...
Technical report for the Swiss government on "Secondary prevention offers and their effectiveness for individuals with sexual interest in children". The report is written in German but contains extended summaries in English, French, and Italian languages.
For more information refer to: https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-80366.html
... Diese geringen Basisraten machen es aus statistischen Gründen schwierig, tertiäre Präventionsprogramme zu evaluieren und zu optimieren. 46 Andererseits werden bis zu 95% aller sexuellen Kindesmissbrauchstaten von Ersttäter(inn)en begangen (Sandler, Freeman & Socia, 2008) und es konnte gezeigt werden, dass sich männliche Sexualstraftäter im Durchschnitt etwa fünf bis zehn Jahre bemühten, ihren paraphilen sexuellen Fantasien und Impulsen zu widerstehen, bevor sie ein Sexualdelikt begingen (Piché, Mathesius, Lussier & Schweighofer, 2018). Diese Befunde legen nahe, dass es sinnvoll sein könnte, die Prävention von Sexualstraftaten auf den sekundärpräventiven Bereich auszuweiten. ...
... Die am häufigsten genannten sexuellen Probleme (rund die Hälfte der Befragten MAPs) betreffen den Bereich sexueller Selbstregulation wie speziell sexuelle Präokkupation (d.h. übermässige gedankliche Beschäftigung mit Sexualität), die Nutzung von Sexualität zur Bewältigung negativer Gefühlszustände und einen aus ihrer Sicht zu ausgeprägten Konsum von Pornografie, wohingegen nur etwa 20% speziell die auf Minderjährige ausgerichteten Aspekte ihrer Sexualität als Problem berichteten (Piché et al., 2018). Eine Mehrzahl der befragten Personen in einer Studie von Houtepen, Sijtsema und Bogaerts (2016) ...
... Entsprechend berichteten zwar 75% der befragten MAPs bei Levenson und Grady (2018), dass sie professionelle Hilfe nachgesucht hätten, aber nur die Hälfte von ihnen erlebte diese als hilfreich. Von den in einer Studie von Piché et al. (2018) befragten MAPs gab nur rund jede fünfte Person an, vorher Hilfe aufgrund sexueller Probleme nachgesucht zu haben, wobei die am häufigsten genannten Gründe für die Nichtinanspruchnahme Scham, Schüchternheit und fehlendes Wissen über Therapiemöglichkeiten waren. ...
Technical report for the Swiss government on "Secondary prevention offers and their effectiveness for individuals with sexual interest in children". The report is written in German but contains extended summaries in English, French, and Italian languages.
For more information refer to: https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-80366.html
... Diese geringen Basisraten machen es aus statistischen Gründen schwierig, tertiäre Präventionsprogramme zu evaluieren und zu optimieren. 46 Andererseits werden bis zu 95% aller sexuellen Kindesmissbrauchstaten von Ersttäter(inn)en begangen (Sandler, Freeman & Socia, 2008) und es konnte gezeigt werden, dass sich männliche Sexualstraftäter im Durchschnitt etwa fünf bis zehn Jahre bemühten, ihren paraphilen sexuellen Fantasien und Impulsen zu widerstehen, bevor sie ein Sexualdelikt begingen (Piché, Mathesius, Lussier & Schweighofer, 2018). Diese Befunde legen nahe, dass es sinnvoll sein könnte, die Prävention von Sexualstraftaten auf den sekundärpräventiven Bereich auszuweiten. ...
... Die am häufigsten genannten sexuellen Probleme (rund die Hälfte der Befragten MAPs) betreffen den Bereich sexueller Selbstregulation wie speziell sexuelle Präokkupation (d.h. übermässige gedankliche Beschäftigung mit Sexualität), die Nutzung von Sexualität zur Bewältigung negativer Gefühlszustände und einen aus ihrer Sicht zu ausgeprägten Konsum von Pornografie, wohingegen nur etwa 20% speziell die auf Minderjährige ausgerichteten Aspekte ihrer Sexualität als Problem berichteten (Piché et al., 2018). Eine Mehrzahl der befragten Personen in einer Studie von Houtepen, Sijtsema und Bogaerts (2016) ...
... Entsprechend berichteten zwar 75% der befragten MAPs bei Levenson und Grady (2018), dass sie professionelle Hilfe nachgesucht hätten, aber nur die Hälfte von ihnen erlebte diese als hilfreich. Von den in einer Studie von Piché et al. (2018) befragten MAPs gab nur rund jede fünfte Person an, vorher Hilfe aufgrund sexueller Probleme nachgesucht zu haben, wobei die am häufigsten genannten Gründe für die Nichtinanspruchnahme Scham, Schüchternheit und fehlendes Wissen über Therapiemöglichkeiten waren. ...
Technical report for the Swiss government on "Secondary prevention offers and their effectiveness for individuals with sexual interest in children". The report is written in German but contains extended summaries in English, French, and Italian languages.
For more information refer to: https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-80366.html
... Diese geringen Basisraten machen es aus statistischen Gründen schwierig, tertiäre Präventionsprogramme zu evaluieren und zu optimieren. 46 Andererseits werden bis zu 95% aller sexuellen Kindesmissbrauchstaten von Ersttäter(inn)en begangen (Sandler, Freeman & Socia, 2008) und es konnte gezeigt werden, dass sich männliche Sexualstraftäter im Durchschnitt etwa fünf bis zehn Jahre bemühten, ihren paraphilen sexuellen Fantasien und Impulsen zu widerstehen, bevor sie ein Sexualdelikt begingen (Piché, Mathesius, Lussier & Schweighofer, 2018). Diese Befunde legen nahe, dass es sinnvoll sein könnte, die Prävention von Sexualstraftaten auf den sekundärpräventiven Bereich auszuweiten. ...
... Die am häufigsten genannten sexuellen Probleme (rund die Hälfte der Befragten MAPs) betreffen den Bereich sexueller Selbstregulation wie speziell sexuelle Präokkupation (d.h. übermässige gedankliche Beschäftigung mit Sexualität), die Nutzung von Sexualität zur Bewältigung negativer Gefühlszustände und einen aus ihrer Sicht zu ausgeprägten Konsum von Pornografie, wohingegen nur etwa 20% speziell die auf Minderjährige ausgerichteten Aspekte ihrer Sexualität als Problem berichteten (Piché et al., 2018). Eine Mehrzahl der befragten Personen in einer Studie von Houtepen, Sijtsema und Bogaerts (2016) ...
... Entsprechend berichteten zwar 75% der befragten MAPs bei Levenson und Grady (2018), dass sie professionelle Hilfe nachgesucht hätten, aber nur die Hälfte von ihnen erlebte diese als hilfreich. Von den in einer Studie von Piché et al. (2018) befragten MAPs gab nur rund jede fünfte Person an, vorher Hilfe aufgrund sexueller Probleme nachgesucht zu haben, wobei die am häufigsten genannten Gründe für die Nichtinanspruchnahme Scham, Schüchternheit und fehlendes Wissen über Therapiemöglichkeiten waren. ...
Technical report for the Swiss government on "Secondary prevention offers and their effectiveness for individuals with sexual interest in children". The report is written in German but contains extended summaries in English, French, and Italian languages.
For more information refer to: https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-80366.html
... Primary and secondary initiatives are even more relevant because up to 95% of sexual offences against children are committed by first-time offenders (Sandler, Freeman, & Socia, 2008). Research has also shown that men who have committed a sex offence may struggle with their sexual thoughts and urges for an average of 5-10 years before committing the sexual offence (Knack, Holmes, Trunzo, & Fedoroff, 2017;Pich e, Mathesius, Lussier, & Schweighofer, 2018), indicating that we, as a society, have time to prevent many of the sexual crimes that occur. While the current article focuses mainly on secondary prevention initiatives, the successful implementation of these initiatives is likely to also require interventions at the primary level in order to address the stigma and misunderstandings about paedophilia (Cooper, 2010;Jahnke & Hoyer, 2013). ...
... For MAP, sexual attraction to children is likely an inherent part of the motivation to engage in CSA, yet research has indicated that other underlying motivators may also contribute to their offending behaviour, including abuse in childhood (Nunes, Hermann, Malcom, & Lavoie, 2013;Sullivan & Sheehan, 2016), cognitive distortions and abuse-supportive attitudes (Helmus, Hanson, Babchishin, & Mann, 2013), desire for intimacy and emotional gratification (Ward, Hudson, & France, 1993), and the use of maladaptive coping mechanisms that may indirectly lead to sexual offending (Ward, Mann, & Gannon, 2007). In some cases, MAP spend years successfully resisting their urge to engage in CSA (Pich e et al., 2018), until the accumulation of multiple life stressors act as a catalyst for the transition from sexual interest to sexual behaviour (Leclerc, Wortley, & Dowling, 2016). Studies have shown that a number of underlying motivations for engaging in CSA are endorsed by those both with and without a sexual interest in children. ...
... McCartan et al. (2018) reported that some individuals were hesitant to search for available services online or disclose their sexual issues to a healthcare provider in order to get a treatment referral, as they were uncertain of the legal consequences of these actions. These findings are in line with another recent study, which found that barriers to treatment included participants' concerns they would be arrested or labelled as a sexual deviant, as well as concerns about privacy and anonymity (Pich e et al., 2018). These concerns may be especially prominent for individuals who are sexually attracted to children but have not acted on this sexual interest. ...
The high prevalence rates and numerous consequences associated with child sexual abuse makes preventing these offences a societal priority. Prevention strategies have traditionally involved only tertiary interventions, implemented by the criminal justice system after an offence has occurred. More recently, some have argued for a public health approach to preventing child sexual abuse, which includes interventions at the primary and secondary levels. Secondary prevention aims to provide treatment and support to those at-risk of sexually offending before any involvement with the legal system. Increased demand for secondary prevention services and early results from current initiatives demonstrate that at-risk individuals are willing to seek treatment without external pressure from the legal system, and often report numerous treatment-related benefits. These findings support the need for widespread implementation of primary and secondary prevention initiatives. The safety of children requires that society stops merely reacting to sexual offences, and instead begins implementing proactive evidence-based strategies that can prevent even initial incidents of child sexual abuse. This article explores some of the many benefits and barriers associated with primary and secondary prevention, as well as strategies for overcoming these barriers. Recommendations for the development and implementation of prevention initiatives are also included.
... Primary and secondary initiatives are even more relevant because up to 95% of sexual offences against children are committed by first-time offenders (Sandler, Freeman, & Socia, 2008). Research has also shown that men who have committed a sex offence may struggle with their sexual thoughts and urges for an average of 5-10 years before committing the sexual offence (Knack, Holmes, Trunzo, & Fedoroff, 2017;Pich e, Mathesius, Lussier, & Schweighofer, 2018), indicating that we, as a society, have time to prevent many of the sexual crimes that occur. While the current article focuses mainly on secondary prevention initiatives, the successful implementation of these initiatives is likely to also require interventions at the primary level in order to address the stigma and misunderstandings about paedophilia (Cooper, 2010;Jahnke & Hoyer, 2013). ...
... For MAP, sexual attraction to children is likely an inherent part of the motivation to engage in CSA, yet research has indicated that other underlying motivators may also contribute to their offending behaviour, including abuse in childhood (Nunes, Hermann, Malcom, & Lavoie, 2013;Sullivan & Sheehan, 2016), cognitive distortions and abuse-supportive attitudes (Helmus, Hanson, Babchishin, & Mann, 2013), desire for intimacy and emotional gratification (Ward, Hudson, & France, 1993), and the use of maladaptive coping mechanisms that may indirectly lead to sexual offending (Ward, Mann, & Gannon, 2007). In some cases, MAP spend years successfully resisting their urge to engage in CSA (Pich e et al., 2018), until the accumulation of multiple life stressors act as a catalyst for the transition from sexual interest to sexual behaviour (Leclerc, Wortley, & Dowling, 2016). Studies have shown that a number of underlying motivations for engaging in CSA are endorsed by those both with and without a sexual interest in children. ...
... McCartan et al. (2018) reported that some individuals were hesitant to search for available services online or disclose their sexual issues to a healthcare provider in order to get a treatment referral, as they were uncertain of the legal consequences of these actions. These findings are in line with another recent study, which found that barriers to treatment included participants' concerns they would be arrested or labelled as a sexual deviant, as well as concerns about privacy and anonymity (Pich e et al., 2018). These concerns may be especially prominent for individuals who are sexually attracted to children but have not acted on this sexual interest. ...
Lunch & Learn Session at the Eastern Ottawa Resource Centre. (Invited)
... Studies have revealed that most MAPs become aware of their unusual sexual interests in early adolescence (B4UAct, 2011b;Buckman, Ruzicka, & Shields, 2016), and that about 42% report a primary attraction to prepubescent youngsters (Mitchell & Galupo, 2016;Piché et al., 2016). Despite wanting help from a mental health professional, most report that they were reluctant to seek services due to beliefs that they would be treated disrespectfully or judgmentally, fears of unethical treatment or breaches of confidentiality, and apprehension that counselors would not have a knowledgeable understanding of minor-attraction (B4UAct, 2011b). ...
... Researchers surveyed 100 convicted sex offenders in treatment in order to understand their awareness of interventions that might have been available prior to offending and their willingness to take advantage of such services (Piché et al., 2016). Results revealed that lack of knowledge and/or restricted access to counseling services as well as fears of being reported to authorities prevented them from talking to professionals about their sexually deviant interests. ...
... More than half said they were ashamed and did not know who to talk to about it. They opined that free therapy services, a telephone helpline, online counseling, or self-help books would have been beneficial resources for them prior to offending (Piché et al., 2016). ...
Persons with potentially harmful sexual interests such as attraction to minors are unlikely to seek or receive treatment before a sexual offense has been committed. The current study explored barriers to help-seeking in a sample of 372 individuals in treatment for sexual offending. Results revealed that the shame and secrecy resulting from stigma associated with pedophilic interests often prevented our respondents from seeking professional counseling, and only about 20% tried to talk to anyone about their sexual interests prior to their arrest. Barriers to seeking and receiving psychological services included concerns about confidentiality, fears of social and legal consequences, personal shame or confusion about the problem, affordability, and challenges finding competent therapists who were adequately equipped to help them. Understanding and ultimately reducing obstacles to help-seeking can improve the quality of life for people with harmful sexual interests and potentially prevent sexual abuse of children or other vulnerable individuals.
... sexual offense struggle with their sexually deviant thoughts or fantasies several years before their offense [17]. A particular challenge arises for individuals with a pedohebephilic sexual interest, as research indicates biases among health professionals regarding treatment of this group [18]. ...
... Web-based programs can provide a lowthreshold opportunity for individuals who seek help, particularly for those scared of being stigmatized. For instance, studies have shown that men who sexually offended struggle with their thoughts up to 10 years before committing an offense, emphasizing the need for further help services [17]. Taken together, all evaluation studies reported in this review support that web-based initiatives to prevent sexual offense perpetration can be considered a good low-threshold alternative or addition to face-to-face treatments and in-person support groups. ...
Web-based programs to prevent sexual offense perpetration could provide an opportunity that avoids many of the barriers associated with in-person treatment. The aim of this systematic review is to give an overview of the literature on web-based initiatives aimed at sexual offense perpetration prevention published during the last 10 years (2013–2023) and to report data on the efficacy as well as issues of the discussed initiatives.
We included 18 empirical studies discussing web-based perpetration prevention initiatives, of which six are randomized controlled trials. Among the articles, four cover programs focusing on prevention of sexual reoffending and 14 discuss programs aimed at preventing initial sexual offenses.
Evaluations and observations of web-based initiatives aimed at preventing sexual offense perpetration show overall promising results and are well-appreciated. However, evaluation studies are scarce and more randomized controlled trials replicating this effect are warranted.
... Addressing this needed update to the deviant sexual fantasy literature is important as a minor percentage of individuals who commit sexual offenses seek treatment for their deviant sexual fantasies. In a sample of convicted males who committed sexual offenses, only 18% sought out treatment for their deviant sexual fantasies (Pich e, Mathesius, Lussier, & Schweighofer, 2016) due to feelings of shame and shyness, not knowing who to talk to, having no one to talk to or thinking treatment was unimportant (Pich e et al., 2016). Additionally, reported barriers for disclosing problematic deviant sexual fantasies were: concern of being arrested if the offender reported their deviant sexual fantasies, being labelled a sexual deviant and concerns about privacy and anonymity (Pich e et al., 2016;Levenson, Willis, & Vicencio, 2017). ...
... In a sample of convicted males who committed sexual offenses, only 18% sought out treatment for their deviant sexual fantasies (Pich e, Mathesius, Lussier, & Schweighofer, 2016) due to feelings of shame and shyness, not knowing who to talk to, having no one to talk to or thinking treatment was unimportant (Pich e et al., 2016). Additionally, reported barriers for disclosing problematic deviant sexual fantasies were: concern of being arrested if the offender reported their deviant sexual fantasies, being labelled a sexual deviant and concerns about privacy and anonymity (Pich e et al., 2016;Levenson, Willis, & Vicencio, 2017). Due to purposeful withholding of information (Marshall et al., 2009;Ware et al., 2015), individuals who commit sexual offenses are often unwilling to disclose the occurrence of deviant sexual fantasies in treatment. ...
Deviant sexual fantasy is identified as a risk factor for sexual offending, yet no study has examined deviant sexual fantasy across the lifespan in nonoffending adult males. To bridge this gap, this study examined the frequencies of normative and deviant sexual fantasies among 318 nonoffending adult males in the United States. Participants were recruited via Amazon Mechanical Turk™. Participants took two inventories that assessed demographics and types of sexual fantasies. Normality tests, means tests, Kruskal–Wallis 1-way analyses of variance (ANOVAs), binary logistic regressions, and odds ratio post hoc analyses were conducted. Deviant sexual fantasies progressively declined across all three age groups, while normative sexual fantasy did not. Results suggest that deviant sexual fantasy changes across the lifespan. Applicability of the findings to applied settings, such as sexually violent predator evaluations, is discussed. Limitations and future considerations are addressed.
... Annual reports also show an upward trajectory across years of operation, with a 38% increase in the number of calls in 2020 (see Gerkens, 2020). Other research has demonstrated that those atrisk of offending would engage with a helpline if available, and individuals who have been convicted for sexual offences would consider using a prevention service like Stop It Now! in the future (Piche et al., 2018) reinforcing the continued demand for these services. ...
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Stop It Now!_Final Report_McKillop_Rayment
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Abstract
The purpose of this project was to undertake a focused study to consolidate the 30 year history of the Stop It Now! movement - a child sexual abuse (CSA) perpetration prevention initiative - documenting main achievements, as well as identifying factors that shaped its development and expansion. Findings are drawn from the experiences of professional stakeholders across respective Stop It Now! sites, including the United States, across the United Kingdom (England, Scotland, Wales, and Northern Ireland), Ireland, Netherlands, Belgium (Flanders), and Australia. Proposed areas for future consideration and discussion questions, derived from study findings, provide a platform from which to share innovative practices, increase collaborations, grow, and learn from one another, and plan future directions for Stop It Now!
... Certainly, having support services and resources available for those with sexual interest in minors (but who are yet to offend) to assist them in abstaining from perpetrating CSA, seems a logical preventative action in which to invest. Indeed, for those who do perpetrate CSA, research has found substantial time lags between the onset of the sexual interests (such as minor-attraction) and first arrest (e.g., Piché, et al. 2016). Hence, as Parr and Pearson aptly state "it begs the question of whether there is a window of opportunity between realizing one's attraction and acting upon it" (p.946). ...
From a public health perspective, ensuring access to, and uptake of, support services for people concerned about their sexual thoughts and behavior is essential to the prevention of child sexual abuse. However, public and fiscal support for these services can be adversely affected by negative preconceptions regarding minor-attracted persons (MAPs); negative stigma may also limit MAPs' engagement with such services. Using a randomized-control design, the present study replicated and extended a recent US study to test effects of different modes of educational messaging to reduce negative attitudes toward MAPs in Australia. Participants were recruited nationally via a Qualtrics XM online survey platform. The final sample (n = 178) were aged 18-84 (M = 47.57 years, SD = 17.34; 49% male). Participants completed the Attitudes Toward Minor Attracted Persons (ATMAP) scale prior to being randomly assigned to one of four conditions (written text [facts only]; written text [myth and facts]; info-video [myths and facts]; and control). Following intervention (or control) the ATMAP was readministered; those in experimental groups also completed a comprehension test. Mixed between-within subjects analysis of covariance revealed significant reductions in pre-post scores on the ATMAP scale, but no significant differences were found across intervention types, or the control. Scores indicated that older participants were less negative in their attitudes compared to younger participants, both before and after intervention. Findings suggest that educating the public may improve attitudes toward MAPs, but more knowledge is required on how to best disseminate messages to maximize impact.
... However, even when they are able to confidentially access services, there is another hurdle to overcome in relation to setting appropriate treatment goals (Hardeberg Bach & Demuth, 2018;Lawrence & Willis, 2021). Establishing a supportive and collaborative therapeutic alliance between MAPs and healthcare providers is crucial in ensuring that sexual attractions to children are managed in the most effective manner possible, that MAPs are supported in their striving for mental wellbeing, and that service users stay engaged with the programs that they are accessing (Levenson & Grady, 2019a;Piché, Mathesius, Lussier, & Schweighofer, 2018). Research with MAPs has established that person-centered approaches to treatment are deemed to be the most successful when looking to cases of formal and informal help seeking (Levenson & Grady, 2019b). ...
Research has shown that people within society experience sexual attractions to children, and a substantial number of these seek support related to this. However, professional practices around working with minor-attracted persons (MAPs) are variable. Clinicians possess low levels of knowledge about this population and are unclear about the correct treatment goals. In this work we explored the prioritization of different treatment goals by MAPs (n = 150), before investigating the demographic, sexuality-related, and psychological predictors of treatment target prioritization. Self-compassion drove many treatment targets among MAPs. We offer recommendations about how professionals might work collaboratively and effectively with this population.
... Primary interventions focus on worldwide initiatives for the general population, secondary preventions focus on the perpetrator or an at-risk child, and tertiary preventions concentrate on the perpetrators who have already offended or children who have already been victims. With first-time offenders making up 95% of CSA cases (Sandler et al., 2008), and research suggesting that it can take up to 10 years before a perpetrator commits CSA (Piché et al., 2018), it appears that primary prevention has a more pivotal role in stopping OCSA. Law and legislation are a crucial part in helping this primary prevention. ...
Online child sexual abuse is highly prevalent in current society, in part, due to how technologically advanced children and adults have become. While much of the focus has been on perpetrator intervention, it is prudent to consider responses safeguarding children from potential perpetrators. Therefore, this review aimed to identify all the available empirical research on the prevention methods linked to education and awareness to determine the approaches' effectiveness, successes, and failures to aid future interventions. Databases were systematically searched for studies published between 2000 to 2020. Nine studies providing different prevention methods for online child sexual abuse were selected. A total sample of n = 672 and a descriptive approach was used for this study. While the interventions seemed to improve knowledge retainment of online safety, there was no significant change for risky online behavior. These findings provide specific suggestions for future interventions, particularly those focusing on risky online behaviors.
... De externe hulp kan zowel informeel zijn, waarbij gebruikgemaakt wordt van hulp uit de eigen sociale omgeving, als formeel, waarbij professionele hulp wordt ingeschakeld. Mensen met seksuele problematieken, zoals een seksuele voorkeur voor minderjarigen, gaan nog minder dan mensen met andere mentale problemen op zoek naar hulp (Piché, Mathesius, Lussier, & Schweighofer, 2019) en maar een klein deel van de MAPs vertellen er ooit iets over aan een hulpverlener (Dombert et al., 2016). Het stigma dat kleeft aan MAPs is immers nog groter dan dat ten aanzien van personen met andere mentale problemen (Jahnke, 2018). ...
Pedofilie is een maatschappelijk gevoelig thema, waarover verschillende misvattingen en stigma’s circuleren. Ook binnen de klinische praktijk blijft het een taboeonderwerp. Veel te vaak wordt pedofilie gelijkgesteld met kindermisbruik. Onderzoek toont echter aan dat heel wat mensen seksuele interesses voor minderjarigen ervaren zonder tot seksueel kindermisbruik over te gaan. De negatieve opvattingen hebben niet alleen impact op het sociale leven en het psychosociaal welzijn van personen met een seksuele voorkeur voor minderjarigen ̶ in het Engels minor-attracted persons (MAPs) genoemd ̶ , het heeft ook invloed op het hulpzoekend gedrag van deze personen. De huidige studie beoogt meer inzicht te verwerven in het hulpzoekend gedrag van MAPs. Uit de resultaten blijkt dat slechts een minderheid hulp heeft gezocht. Vooral formele hulpbronnen of hulp door professionals lijken van belang in hun zoektocht naar hulp, maar de drempel ernaartoe blijft groot. Niet alleen duidelijkheid rond de toegang en de beschikbaarheid van formele hulpbronnen zijn noodzakelijk om de zoektocht naar gepaste hulp te faciliteren, ook de houding en attitude van hulpverleners ten aanzien van MAPs spelen een belangrijke rol. In deze bijdrage wordt besproken hoe bestaande initiatieven hier reeds op anticiperen, ook worden aanbevelingen geformuleerd over de wijze waarop het bestaande hulpaanbod beter kan aansluiten bij de noden van MAPs.
... Primary and secondary prevention of sexual offending has become a growing area of interest, and there are early indications of the benefits of such initiatives that have been indicated in the field generally (e.g. Knack et al., 2019;Piché et al., 2018). Based on some limited relevant data available in this thesis (see Chapter 3), it may be useful for primary interventions to target autistic individuals who are at secondary school age, with a specific focus on improving sexual education and online safety education for autistic children and adolescents. ...
Research indicates that autistic individuals are no more likely to offend than anyone else in the general population. However, it has been suggested that when autistic individuals do offend, their offending behaviour can be contextualised by their autism. One of the most common forms of offending reported to be committed by autistic individuals are sexual offences, and research has outlined how autism can contribute to those offences. Additionally, recent research has also indicated that autistic prisoners may experience unique challenges and have specific support needs during their prison sentences, which potentially differ from their non-autistic peers. Despite this, little research has specifically explored how to work with, support and manage autistic individuals with sexual offence convictions (ISOCs) in prison-based interventions to address sexual offending.
This thesis details an exploratory sequential mixed method approach used to explore effective work practices with autistic ISOCs in prison-based interventions to address sexual offending. Specifically, this thesis explored the following research questions; 'How appropriate are current prison-based sexual offending interventions for autistic ISOCs?' And 'What is best practice when working with autistic ISOCs in prison-based sexual offending interventions?'. To answer these research questions, the thesis sought to: (i) identify challenges associated with prison-based sexual offending interventions for autistic ISOCs; (ii) identify beneficial features of prison-based sexual interventions for autistic ISOCs; and (iii) to generate evidence-based, practical recommendations on how to work with autistic ISOCs in prison-based sexual offending interventions.
This thesis is constructed of six chapters. Chapter 1 provides a broad introduction to the topic background and rationale of the thesis, concluding with the overarching research questions and aims. Chapter 2 provides a discussion of the methodological issues that were relevant to the empirical studies of the thesis, including a rationale for the mixed method design. Chapter 3 reports Study 1, which was a qualitative narrative exploration of the life stories of autistic ISOCs (N= 4). This study incorporated an inclusive, participatory autism research approach, and discusses how diversity and similarities in those life stories may be relevant for interventions. Chapter 4 reports Study 2, a multi-perspective qualitative study that utilised a phenomenologically informed thematic analysis to explore the issues surrounding working with autistic ISOCS in prison-based interventions to address sexual offending, from the perspectives of autistic ISOCs (N= 12) and staff (N= 13). Chapter 5 details Study 3, a quantitative study that sought to confirm qualitative findings reported in Chapter 4; relating to the relationships between autistic traits, the prison social climate, mental wellbeing and readiness to 6 engage with interventions in a sample of ISOCs serving prison sentences (N= 177). Finally, Chapter 6 provides a synthesis and general discussion of the collective findings from the empirical studies. Chapter 6 also details practical recommendations for working with autistic ISOCs in prison-based sexual offending interventions, directions for future research, highlights the original contributions of the thesis, considers broader limitations of the research, and offers a final conclusion.
... Термин предаја употребљен је код оба кривична дела. С тим у вези, треба имати у виду чињеницу, да кривично дело трговина људима из члана 388 став 2 КЗ, када се на страни пасивног субјекта налази малолетно лице, не захтева да се подстрекавање или помагање врши на неки од начина које иначе предвиђа ово кривично дело (Делибашић, 2010: [58][59]. Када је у питању тежи облик кривичног дела, неопходно је да умишљај обухвати и свест да се ради о малолетнику. ...
Видео игре су најбрже растући и еволуирајући производ индустрије забаве, и као такве, постале су један од најчешћих избора за провођење слободног времена. Различита истраживања указују да видео игре одавно нису забава за децу, да је старост просечног играча близу четрдесет година и да је 29% играча старије од 50 година. Индустрија видео игара и сродна индустрија прате тај тренд, па је већина платформи и система за играње видео игара предвиђена за старије од 18 година.
Међутим, засићењем тржишта дошло је до тога да постоји видео игра за сваког, а развојем интернета играње онлајн, заједно са другим играчима, постала је неодвојива компонента видео игара, чак толико да су неке од најпопуларнијих видео игара предвиђене искључиво за онлајн играње. Самом чињеницом да играњем онлајн ступате у контакт са осталим играчима отвара се могућност за потенцијалне злоупотребе. Иако поменути сервиси за играње имају старосна ограничења, која су најчешће постављена на 13+ година, постоји, како могућност да се давањем лажног исказа сервисима приступи, тако и постоје игре где је
старосни лимит јако низак. Опасност од злоупотреба, па чак и криминалног понашања је појачана психолошким механизмима који настају приликом играња видео игара у тиму, и стиче се веће поверење и осећај познавања него што је то стварно. Ипак, канали комуникације који постоје у видео играма ипак нису најподесније средство за комуникацију између педофила и деце, али треба нагласити да опасност лежи у могућности да тај виртуелни и интерактивни однос мигрира на подеснију платформу, као што су друштвене мреже, чет собе и остало.
Аутор, такође, наводи примере садржаја са елементима педофилије који се налазе у видео играма, делећи их у две групе према уграђеном етичком односу према том поремећају. У првој групи су игре у којима је присуство педофилије успутно и са јасно одређеним етичким односом који је у складу са друштвеним нормама, док су у другој игре где је педофилија основ наратива, и те игре су најчешће изведене из јапанских еротских жанрова манга 4 стрипова. На крају аутор закључује да опасност од педофила у онлајн видео играма може да се значајно умањи
подизањем нивоа безбедносне културе како код деце, тако и код родитеља.
Кључне речи: видео игра, педофилија, онлајн играње, комуникација,
поверење, интерактивни однос, безбедносна култура
... Термин предаја употребљен је код оба кривична дела. С тим у вези, треба имати у виду чињеницу, да кривично дело трговина људима из члана 388 став 2 КЗ, када се на страни пасивног субјекта налази малолетно лице, не захтева да се подстрекавање или помагање врши на неки од начина које иначе предвиђа ово кривично дело (Делибашић, 2010: [58][59]. Када је у питању тежи облик кривичног дела, неопходно је да умишљај обухвати и свест да се ради о малолетнику. ...
The transformative influence of the Internet on every aspect of human life and activity is so all-reaching that only by deep abstraction we can recall how life went on before its broad distribution. In its essence a communications technology, the Internet brought the most drastic change to the way we receive and send messages of every kind. And while in most cases it was an exceptional benefit, human nature remained unchanged, so a
part of the vast global network became a ground for the expression of various negative tendencies, from asocial and antisocial to outright criminal ones. Due to its decentralized nature and a practical impossibility for the regulation of the largest part of the Internet, it began to host and make available content and possibilities that are on the other side of both the law
and the public morals. Pornography is generally the most searched term on the Internet, and pornographic websites and platforms host vast collections of pornographic content. And while the mainstream part of the Internet is regulated in a certain measure, the remaining part is not, and in that virtual and practically unlimited space sexual predators, including pedophiles, can satisfy their urges and tendencies in ways that are not possible in the purely physical world. Internet pedophiles can contact potential victims far easier, as well to access and distribute child pornography content. Almost every communications platform on the Internet brings the danger of involvement of pedophiles, and they can communicate with
potential victims without fear of being noticed and caught. Security services fight pedophilia on the global network as well, but due to the nature of the problems results are marginal. The key role in the prevention of the Internet pedophilia is in raising of awareness level of importance of security culture on the Internet in parents and children – as the parents have prepared children for dangers in the physical world, they have to prepare them for potential dangers in the virtual world of the global network as well.
... Термин предаја употребљен је код оба кривична дела. С тим у вези, треба имати у виду чињеницу, да кривично дело трговина људима из члана 388 став 2 КЗ, када се на страни пасивног субјекта налази малолетно лице, не захтева да се подстрекавање или помагање врши на неки од начина које иначе предвиђа ово кривично дело (Делибашић, 2010: [58][59]. Када је у питању тежи облик кривичног дела, неопходно је да умишљај обухвати и свест да се ради о малолетнику. ...
Pedofilija je oblik parafilije, koji karakterišu konstantne i intenzivne seksualne fantazije, nagoni ili ponašanja koja uključuju decu (obično do 13 godina starosti). Ova simptomatologija je procentualno izraženija kod muškaraca u odnosu na žene, mada je uočeno da je ta vrsta devijantnosti kod žena dosta perfidnija i diskretnija. Pedofilija je prisutna svuda i može se pronaći u svim društvenim slojevima, bez obzira na materijalni status, obrazovanje ili religiju. Pojedine pedofile privlače samo dečaci, druge samo devojčice, a postoji i treća kategorija ovih osoba koje imaju sklonosti prema oba pola. Neki pedofili pokazuju suptilne naklonosti prema deci sa od-ređenim fizičkim svojstvima (starosna dob, konstitucija, lice, kosa, glas,itd.), dok su drugi manje „probirljivi“. Pretežno su ove osobe sa poremećenom strukturom ličnosti, poznate detetu. Mogu biti članovi uže ili šire porodice ili persone sa autoritetom, poput učitelja ili trenera. Određeni,pak, ispoljavaju incestoidne tendencije i postupke, jer ih privlače isključivo deca iz sopstvene porodice. Ovo je tema o kojoj se uglavnom ne govori glasno. Mnogi članovi porodice će izbegavati obelodanjivanje i pokušati da se sami izbore sa problemom, u protivnom će se suočiti sa javnom osudom i nositi društvenu stigmu. Samim tim, dete-žrtva izlaže se dodatnim rizicima po mentalno i fizičko zdravlje.
... Clearly such laws are intended to protect children from harm by reporting unlawful sexual behavior and plans for such behavior. However, MAPs have described instances where breaches of confidentiality have occurred even when the client disclosed only thoughts or feelings about children but not actions or intentions (B4UAct, 2017;Buckman et al., 2016;Houtepen et al., 2016;Levenson et al., 2017;Piché et al., 2016). Concerns about privacy create a formidable barrier to help-seeking prior to offending. ...
Sexual abuse prevention efforts should ideally include counseling for people who have attractions to children before they offend. Due to a variety of factors, many therapists do not wish to work with this population. The aim of this pilot project was to create, implement, and evaluate a short training workshop to help prepare clinical therapists ( n = 94) to respond ethically and effectively to individuals seeking counseling for pedophilic interests. Data were collected at four different clinical-therapy professional conferences over the course of 14 months. The pretest/posttest design asked questions about six specific areas of knowledge related to pedophilia, mandatory reporting, treatment needs, and goals for this difficult-to-reach population. In addition, six questions were asked about attitudes toward working with minor-attracted persons and capacity to build a therapeutic relationship. Some significant changes were detected in knowledge and attitudes about clients with pedophilia after receiving training about the topic, indicating increased willingness to work with this population and improved feelings of competence in providing services. Implications for prevention are discussed.
... Finally, the authors suggest more resources towards prevention and education on college campuses. Piché, Mathesius, Lussier, and Schweighofer (2018) suggest that primary prevention strategies need to be available, as their study indicated that men who progress towards sexual offenses are interested in prevention and need information related to the support available. Many campuses offer prevention programs that focuses on bystander intervention; however, the authors also recommend collaboration with campus groups to focus prevention efforts on enthusiastic consent campaigns, attitudes toward women and violence, education related to healthy sexuality, and education on rape myths and rape myth acceptance reduction. ...
In this article, the authors discuss the pathways to sexual offenses, risk factors, treatment, and unique ethical challenges inherent in working with students who have a history of sexual offending behavior or exhibit risk factors for such behavior. We also address unique clinical competencies and knowledge and provide recommendations for clinicians who find themselves in a position of having to work with such students despite contraindications. Finally, we explore the consideration of implementing a systems approach to mitigate risks posed by a student with sexual behavior problems by way of the college or university’s behavioral assessment or intervention team.
... Child abuse reporting mandates are designed to protect children from harm, and social workers must adhere to state laws. MAPs have described instances, however, where breaches of confidentiality have occurred even when the client disclosed only thoughts or feelings about children but not actions (B4UAct 2017; Buckman et al. 2016;Houtepen et al. 2016;Levenson et al. 2017;Piché et al. 2016). As a result, concerns about privacy can create a substantial obstacle to help-seeking prior to offending McPhail et al. 2018). ...
Would you feel prepared if a client in your clinical practice shared that he was sexually attracted to children? Mental health professionals come in contact with these individuals primarily through the child welfare or criminal justice systems. But it is now increasingly evident that a population exists of non-offending minor-attracted persons (MAPs) who have never molested a child and have no intention of doing so. By becoming familiar with their unique treatment needs, clinicians can develop competence to provide effective, ethical, and compassionate services for this stigmatized and hard-to-reach population, with a dual focus on sexual abuse prevention and client well-being. This article will first describe what is known about pedophilia and minor-attraction. Next, the legal and ethical questions that therapists may ask in relation to this work will be explored. This paper will review obstacles to help-seeking identified by MAPs and discuss their treatment needs. Finally, recommendations will be offered for engaging MAPs in an emotionally safe and non-shaming therapeutic encounter. In this way, clinical social workers can contribute to advancing child sexual abuse prevention efforts.
... Ceci ne pouvait s'expliquer par la motivation initiale des ACS, puisque ces derniers avaient tous vocalisé un désir de participer au programme intensif. Quatrièmement, en mettant l'accent sur le pénal, le modèle canadien requiert qu'un individu ayant une déviance sexuelle soit passé à l'acte envers une victime, ait été appréhendé par les forces policières et ait été reconnu coupable pour qu'il puisse accéder à des programmes de traitement pour ACS (Piché, Mathesius, Lussier, & Schweighofer, 2018). Considérant que les individus ayant des besoins en matière d'intervention sont déjà peu susceptibles de demander de l'aide par peur de représailles légales, ces derniers doivent en plus composer avec une offre de services anémique pour les individus non judiciarisés. ...
Le présent article propose un regard actuel sur l’évolution des politiques pénales nord-américaines concernant les auteurs de crimes sexuels. L’approche américaine axée sur la dissuasion est comparée à l’approche canadienne, davantage centrée sur la réhabilitation. Les mécanismes qui caractérisent ces deux approches ainsi que leur efficacité respective sont comparés. Plusieurs constats émergent. L’approche américaine bénéficie de très peu de support empirique et est ancrée dans des idéologies conservatrices populistes plutôt que les données probantes. Ce faisant, ses effets secondaires sont susceptibles d’aller à l’encontre de son objectif principal, soit de diminuer le volume de crimes sexuels. L’approche canadienne, qui repose sur des idéaux de la psychologie correctionnelle axée sur une gestion du risque, repose quant à elle sur des données probantes. Toutefois, ce cadre conceptuel confine les contrevenants au statut de « délinquant sexuel », dont l’étiquette cache une réalité beaucoup plus complexe.
... These efforts involve both outreach and therapy (Beier et al., 2009;Lasher & Stinson, 2017). While a number of distinct treatment models have been proposed, the literature suggests several common elements to working with this population (B4U-ACT, 2011b; Lasher & Stinson, 2017;Levenson et al., 2017;Piché, Mathesius, Lussier, & Schweighofer, 2016). The primary aims of these approaches can be summarized as follows: ...
Elevated suicidal risk has been documented in adults who are sexually attracted to minors but the topic has not been adequately investigated, particularly outside the context of the criminal justice system. In this study, risk factors for chronic suicidal ideation were assessed in 333 community-based minor-attracted persons (95% male) via an online survey. Chronic suicidal ideation was endorsed by 38.1% of the participants but was associated neither to history of sexually engaging with a child nor to prior contact with the criminal justice system. In bivariate logistic regression analyses, significant unadjusted correlates included young age, less education, prior mental health treatment, weaker attraction to adult women, history of sexual abuse in the participants’ own childhood, and the psychosocial effect of perceived stigma against pedophilia. In multivariable analysis, all these factors except education were uniquely associated with suicidal ideation. These results identify meaningful clinical risk factors and treatment targets in this population.
... Some studies have indicated that for about 42% of MAPs, their primary attraction is to prepubescent minors, which could mean that they meet the criteria for pedophilic disorder according to the Diagnostic and Statistical Manual of Psychiatric Disorders (5th ed.; DSM-5;American Psychiatric Association, 2013;Mitchell & Galupo, 2016;Piché, Mathesius, Lussier, & Schweighofer, 2018). The DSM-5 distinguishes between pedophilic interests (intense and persistent sexual interest in prepubescent children) and pedophilic disorder, which requires fantasies, urges, or behaviors involving sexual activity that persist beyond 6 months and cause marked distress, interpersonal difficulty, or harm (or risk of harm) to others (Merrick, 2016). ...
Minor-attracted persons (MAPs; N = 293; 154 completed all questions) responded to 10 open-ended questions that were designed to capture in their own words their experiences of seeking treatment. We conducted a qualitative analysis of their responses using grounded theory, which is designed to allow themes to emerge from their responses without preconceived notions or expectations. Using this method, we coded answers and then calculated the total number of times that each theme was cited across the entirety of the survey. The most prominent theme that participants cited in their responses was the experience and/or fear of stigma (n = 87). Stigma plays a significant role in their willingness to engage in the treatment process. Some participants noted their concerns about how some attractions to minors should be viewed as “normal” and is unfairly stigmatized (“normalizing”; n = 63). Other prominent themes included shame (n = 50), which focused on internal views of themselves as a “bad person”; a perceived lack of understanding by professionals about MAPs (n = 50); and the importance of building a community with other nonoffending MAPs (either in person or online; n = 45). In addition, other identified themes included fear of being judged (n = 31), statements that they had never acted on their attractions (n = 31), and a fear of being reported (n = 31). Implications for practice and policy are discussed.
... Some college students who are sexually aggressive are likely capable of change and it may be a missed opportunity that the vast majority of campus behavioral health counselors and sexual assault programs do not retain counselors with training in the treatment of people who have committed sexual offenses. Given that one recent study found that the majority of a sample of men who were charged with or convicted of sex offenses said that they would have been interested in participating in group or individual preventive therapy prior to offending, but that the inaccessibility of these types of services prevented it (Piche et al. 2018), the idea of making sex offending counseling services that are tailored for college students available on campus becomes compelling. A fourth thought experiment: What if colleges invested in providing education and counseling services to people who perpetrate sexual assault, just as they do for those who experience sexual assault? ...
This article proposes new approaches to sexual violence prevention on college and university campuses in the United States. The author conducted four thought experiments about possible college sexual assault prevention strategies based on personal experience with campus administrators and sexual assault prevention specialists, review of existing research, and conversation with undergraduates and graduate students engaged in sexual assault prevention. Both advantages and drawbacks of each potential new strategy were contemplated. The four thought experiments were: (1) What if campuses stopped investing in sexual assault prevention and invested in fighting structural oppression instead?; (2) What if the mission to change social norms was not limited to campus, but aimed at the macro level?; (3) What if sexual assault prevention experts were trained in consent and pleasure related to kink, anal sex, and group sex?; and (4) What if colleges and universities provided on-campus education and counseling options for people who perpetrate sexual assault? First, encouraging a “root cause” perspective on sexual assault prevention would be strategic and socially responsible, but might be difficult to enact. Second, social norms change strategies that are global, not local, might be effective but might require an unrealistic level of cooperation between schools. Third, more information about consent as it pertains to kink, anal sex, and group sex may be useful components of sexual assault prevention education. Finally, there are too few evidence-based programs for people who have perpetrated sexual assault on campuses. Thought experiments are inexpensive to conduct and may invigorate the field. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
... • Prevention Project Dunkelfeld: Nearly half of the 358 participants interviewed had never had sexual contact with a minor ( Self-reported;Beier et al., 2009) • Piché, et al., 2016) • The Current Situation in the UK ...
This presentation outlines a retrospective exploration of viable prevention strategies - helping individuals to avoid committing their first sexual offence against a child
... • Stop it Now: 13.5% of calls from adults concerned about their own sexual thoughts/behavior had not committed any offence (self-reported; Brown et al., 2014) • Prevention Project Dunkelfeld: Nearly half of the 358 participants interviewed had never had sexual contact with a minor (Self-reported;Beier et al., 2009) • Research estimates a time frame of almost a decade between onset of sexual fantasies and the time of the first arrest (Piché, et al., 2016) The Current Situation in the UK ...
This presentation discusses the need for a prevention project and explores help-seeking behaviour in individuals convicted of sexual abuse.
... As long as the social consensus remains punitive in nature, these kinds of preventative and rehabilitative schemes are unlikely to be accessible to those who need help, through fear of social and judicial reprisals, and self-stigmatization (Jahnke & Hoyer, 2013;Piché, Mathesius, Lussier, & Schweighofer, 2016). ...
Much research has examined the views held by citizens about sexual offenders and related policy responses. Although studies have extensively examined demographic correlates of such views, little attention has been paid to psychological mechanisms that underpin them. Gaining a deeper understanding of such mechanisms may ultimately prove useful for informing communication strategies around the problem of sexual violence. We propose the application of moral foundations theory as a means of exploring the roots of the current punitive consensus around sexual crime policy at the macro level, as well as individual variability in attitudes about sexual violence. Following an overview of the sexual offender policy landscape, and a description of MFT principles, we outline how this framework can help to explain both convergence and divergence in responses to sexual offending among members of the public. We also provide a series of testable hypotheses to stimulate further research in this area.
The provision of effective mental health services to individuals attracted to children is rapidly expanding. However, these services have not yet been integrated into general mental healthcare systems and are mainly offered by organizations that predominantly provide services to child sexual abuse perpetrators. Little is known about the perspective, treatment goals, and approaches employed by prevention-specialist mental health professionals when working with clients attracted to children. To address this gap, we used purposive sampling to recruit 10 practitioners who had experience of working in prevention settings with clients attracted to children. After conducting semi-structured interviews and analyzing data through interpretative phenomenological analysis, we identified three main themes and four subthemes within the data. While most participants believed that attraction to minors is unmodifiable or doubted the possibility of modifiability, this belief did not necessarily manifest in their practice. Participants stressed the importance of finding safe alternatives for clients and highlighted the significance of accessing evidence-based information on alternative sexual outlets, such as sex dolls. One overarching theme that emerged across all themes and within participants' accounts was the concern of escalation, indicating a fear that pedophilic fantasies or alternative sexual outlets such as sex dolls could potentially lead to sexual offenses. The findings shed light on the approach of prevention-specialist mental health professionals in working with clients attracted to children and may be used to inform future intervention plans to facilitate service provision to this population.
İnternetin dünya tarihine girmesiyle hız kazanan teknolojik ilerlemelerin etki ettiği alanların sayısı günden güne artmaktadır. Bu etkiler çok yönlü olmakla birlikte bazı olguların evirilmesine de aracılık etmektedir. Bilgi ve iletişim teknolojilerinin yaygınlaşması, internet kullanımının artması her yaşta bireylere yeni kullanım alışkanlıkları edindirmiştir. İnternet kullanımının yaygınlaşması ile beraber çocukların da dijital platformlarda geçirdiği zamanın arttığı bilinmektedir. Bu zaman çocuklar için eğlence, öğrenme, zaman geçirme gibi nitelikler barındırsa da aynı zamanda sanal platformlarda çeşitli biçimlerde cinsel istismara maruz kalma potansiyeli taşımaktadır. Çevrim içi çocuk cinsel istismarının yaygınlığının dikkat çekmesi ve konuya ilişkin literatürün giderek artmasıyla birlikte, bu konudaki temel tanımlayıcı ve açıklayıcı kavramlara ve bilgilere ihtiyaç artmaktadır. Bu çalışma literatür taraması yoluyla, çevrim içi çocuk cinsel istismarı kavramı ve kapsamı hakkında bilgi vermeyi amaçlamaktadır. Çalışma aynı zamanda sosyal hizmet perspektifinden konunun çocuk ve aile refahı için önemine dikkat çekerek uygulayıcılar ve yeni araştırmacılar için birtakım önerilerde bulunmayı hedeflemektedir.
The prevalence and impact of sexual abuse is of global concern, and the alarming rates of victimization have inspired a focus on its prevention. Whilst research has begun to explore the experiences of non-offending individuals to inform prevention initiatives, there is limited exploration of those who have struggled with their sexual interests and go on to commit sexual crime. Arguably these individuals hold key information about gaps in service provision, which may inform approaches to crime prevention. This study aimed to provide a phenomenological exploration of the pre-offense experiences of convicted individuals' beliefs about help-seeking, their desires for support, and any barriers that might have prevented them from coming forward for help. Semi-structured interviews were conducted with 14 individuals convicted of sexual offenses (n = 13 against children; n = 1 sexually motivated violence), and interpretative phenomenological analysis elicited three superordinate themes: Desperation, Barriers to Help-seeking and A Way Forward. The findings shed light on the distressing experience of living with sexual interests that are so openly rejected by society and the many ways participants attempted to cope with this, including multiple failed attempts to seek help. Implications and limitations are discussed.
Help-seeking behaviour in minor-attracted persons (MAP) has received only little attention in the literature and in practice. Recent research however shows that numerous offending and non-offending MAP experience the need to seek help, and a subgroup dares to seek help from formal and informal sources. But their quest for adequate help is anything but easy: MAP are confronted with various obstacles that prohibit them from acting upon a voluntary need for help. The current chapter takes stock of current theoretical and empirical knowledge on help-seeking behaviour in general and in MAP. We will also explore how to further empirical research of this process and how to overcome common obstacles in the current mental health field to facilitate help-seeking behaviour in MAP.
Preventing child sexual abuse (CSA) requires comprehensive multi-agency criminal justice and public health approaches. Yet, marginal attention has been given to secondary prevention strategies that target “at risk” populations. Thus, we carried out a scoping review examining secondary prevention interventions for people at risk of sexual offending by considering their effectiveness, challenges and barriers. We identified N = 43 sources and completed a qualitative analysis. Our appraisal found five themes: (a) essential features needed for secondary prevention programmes (plus summary of interventions); (b) barriers to examining, implementing and accessing secondary prevention programmes; (c) methodological limitations; (d) the ethical justification; and (e) economic benefits for preventing abuse before it occurs. Over the last two decades, sources report greater public tolerance to the notion of tackling CSA using public health prevention approaches. Thus, we call for policy makers to embrace this positive shift and invest resources to further examine this area.
Practice impact statement
Advancing clinicians’ and therapists’ practice is critical for those working with people at risk of harm. This review aims to strengthen current knowledge and inform practice. Further, policy makers and funders are essential to the development and progression of prevention strategies; by providing this contemporary review, we hope to assist the decision-making process for allocating resources and strengthening confidence in advancing policy that builds comprehensive prevention approaches.
Background
In 2012 the Swedish Helpline project PrevenTell, targeting men and women with self-identified out-of-control and paraphilic sexual behavior, was launched by ANOVA, Karolinska University Hospital. The overall purpose was to reach the target group and via a telephone-contact encourage further on-site assessment and treatment.
Aim
To describe men and women contacting PrevenTell during the first 7 years by delineate sexuality-related risk-factors for sexual violence, gender differences, and age- and gender-preferences when reporting a pedophilic interest.
Method
A 52-item semi-structured telephone interview was conducted by experts in sexual medicine with individuals who contacted the helpline. The interview covered sociodemographic characteristics, problematic sexual behavior(s), and mental health and based on the information reported, interventions included recommending an appointment at ANOVA, supporting other appropriate healthcare, or motivation of individuals still ambivalent to treatment.
Results
Data collection took place between March 2012 and October 2019. A total of 1573 respondents in the main target group (1454 men and 119 women) gave informed consent for participation. Compulsive sexual behavior was reported by 69% of respondents and 56% described at least one paraphilic interest. The prevalence of concomitant compulsive sexual behavior and a paraphilic interest was high, varying between 65% and 83%.
Significant gender differences were found in socioeconomic and mental health variables, in which women showed fewer positive and stable life factors compared to men. A sexual preference for minors was reported by 24% of respondents. In this group, 63% reported use of child sexual exploitation material and 15% committed child sexual abuse. Respondents were offered anonymity, however 55% disclosed their identity and were enrolled for further assessment and treatment at ANOVA.
Clinical Implications
The result of this study is of substantial relevance when developing secondary preventive initiatives targeting sexual violence in the community.
Strengths and Limitations
This is the first study to present data from a national helpline targeting both men and women with a wide range of self-identified problematic sexual behaviors. Limitations include the lack of diagnostic confirmation on-site, hence, presented data provides only an indication of clinical conditions. Furthermore, the main objective of the interview was to motivate participants to seek further treatment, sometimes necessary to prioritize this over adherence to the semi-structured questionnaire, explaining the relatively high absence rate in some variables.
Conclusion
Men and women at risk of committing sexual crimes can be reached through a national helpline service and motivated to undergo further assessment and treatment.
The sexual abuse of children is a serious social problem that must be prevented through distinct measures. Among them is the application of treatments to those who have already committed sex crimes in order to prevent them from committing a new one. To assess the efficacy of sexual offense treatment, the most common method has been to compare the recidivism rates of treated and untreated groups. Several meta-analyses in this regard—as well as some specific studies in Spain—have shown that the application of treatment is associated with lower recidivism rates. However, the analysis of the subjects’ recidivism alone does not reveal the therapeutic changes that the treatment may elicit in them. Some international studies have evaluated the therapeutic improvements resulting from the application of treatments to men who had sexually abused children. In this context, this study explores the therapeutic changes experienced by a sample of subjects imprisoned for child abuse ( N = 145), after participating in the treatment program applied in the Spanish prison system. Nine therapeutic variables were assessed (such as anxiety, cognitive distortions, impulsivity, and social self-esteem), before and after treatment, using an instrument named the Psychological Assessment Scale for Sex Offenders (PASSO). The obtained results show that most of the assessed therapeutic variables improved after treatment, with strong correlations between them. The implications of the results for treatment practice are discussed, as well as the main methodological limitations of this research.
There is a desire and need among minor attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated the prevalence of these disclosures, clinician stigma, treatment priorities, and professionals’ willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.
Minor Attracted Persons (MAPS) are individuals who have a sexual interest towards minors but suppress this attraction; understanding the impact it would have on a child’s life. MAPS are a highly stigmatised and isolated population with many developing various mental health disorders including suicidal ideation. MAPS face significant challenges when attempting to pursue professional support for their mental health, such as judgmental attitudes and confidentiality breaches. MAPS are more likely to access counsellors for support, however, there is a lack of pre-existing research exploring UK counsellors opinions, understandings, and attitudes of the MAP population. Twelve counsellors completed a semi-structured skype interview, answering questions surrounding a vignette based on a hypothetical MAP. Eleven interviews were included in the final analysis. A critical realist thematic analysis was conducted. Four themes and four subthemes emerged, Theme 1, ‘An Understanding Response’ with he Subthemes 'Feeling Empathy and Sympathy' and 'Offering an Empathetic & Non-Judgemental Space, Theme 2, ‘Barriers to Counselling’, Theme 3, ‘Handling the Disclosure’ with the Subthemes 'Assessing Risk' and 'Maintaining Sensitivity' and Theme 4, '‘A Need for Training’. Themes encompassed participants feelings towards the client, their approach to counselling, participants willingness and knowledge of working with MAPS and barriers encountered by the participant and MAPS during counselling. Findings are discussed in relation to current research and strengths, limitations, and future recommendations were explored.
The stigmatization of people with pedophilia was previously identified as a “blind spot” in stigma research. This systematic review updates and expands on Jahnke and Hoyer’s 2013 review to understand (1) factors contributing to stigma toward people with sexual interest in children, (2) experiences of stigma, and (3) how stigma can be challenged and reduced. Thematic synthesis was used to analyze data from 35 studies from the United Kingdom, United States, The Netherlands, Germany, Canada, Norway, Australia, and New Zealand. Overarching themes were (1) misperceptions and stereotypes, (2) negative affective responses, (3) discrimination, (4) mental distress, (5) internalized public stigma, (6) negative effects of disclosure, and (7 and 8) informative and humanizing interventions. Findings highlighted substantial prevalence of stigma toward and amongst people with sexual interest in children, and methodological limitations of extant research. An agenda for future research is discussed, emphasizing how stigma can be challenged.
Sexual abuse prevention efforts need to focus on understanding the potential risk factors and treatment needs of minor-attracted persons (MAPs). The aim of this exploratory study was to describe the adverse childhood experiences (ACEs) of male MAPs and compare these to rates of ACEs in the general male population (n = 7,970) and in groups of individuals who have been convicted of sexual offenses (ISOs, n = 679). The participants were a nonrandom, purposive sample of MAPs (n = 293; 116 men completed all questions) who participated in an online anonymous survey. The ACEs with the highest frequencies were verbal/emotional abuse (75%) and bullying by peers and siblings (78%), with around a quarter stating that these events occurred “very often” (20% and 29%, respectively). Also, a majority of the MAPs (52%) had an ACE score of 4 or more, and fewer than 10% had an ACE score of one. Compared to the general male population, they were more likely to have experienced almost every form of ACEs and were almost 40 times more likely to have experienced emotional abuse and more than 8 times more likely to have experienced emotional neglect. In contrast, there were fewer differences with the ISOs, but MAPs reported more child maltreatments (i.e., emotional abuse and emotional neglect) compared to the ISOs who, other than sexual abuse, had higher rates of family dysfunction (i.e., domestic violence and substance use in the home). Implications for prevention and intervention are discussed, including the need for a trauma-informed approach when working with MAPs.
PREVENTION OF CHILD SEXUAL ABUSE:
PARENTAL AND SOCIAL INVOLVEMENT
Summary: Prevention of Child Sexual Abuse is essential in every society considering
the perimeter and long term consequences that problem causes. Child Sexual Abuse is a
multifaceted problem according to its characteristics, dynamics, causes and consequences.
Risk factors for this form of child abuse vary in children's developmental stages and environments they are developing, including institutions (preschools, schools, sports clubs)
where children have the opportunity to form close relationship with adults outside the home
and out of parent’s control. Numerous studies have shown that high level of Child Sexual
Abuse happens by person who is very close to the children’s family, so parent’s role in preventive sense is crucial. Based on a literature review, international practice and analysis of
relevant prevention programs, which has been used over the world, it is evident that parents
have dominant role in the prevention and early detection of Child Sexual Abuse. The content
of the prevention programs aimed to parents mainly involves teaching children protective
behavior, identifying characteristics of the perpetrators and encouraging parents to report
case of Child Sexual Abuse. Previous experience in our country suggests that most of prevention activities are focused on a tertiary prevention carried out by Criminal Justice System
after the commission of the offense. The purpose of this paper is to analyze prevention programs in the world which has achieved good results in Child Sexual Abuse prevention, give
guidelines for a better problem understanding by parents and relevant social factors as well
as the organization and implementation of appropriate prevention programs in our child
protection system. This paper explores some of the many advantages and disadvantages
associated with primary and secondary prevention, as well as ways and means to overcome
some problems.
Key words: Child Sexual Abuse, parents, prevention, pedophilia
Paraphilias include sexual arousal to uncommon objects, situations, and/or target groups (i.e. children, animals, corpses). Certain sexual activities that might look odd to another person or a health worker are not paraphiliac disorder just because they are odd. Individuals can have paraphiliac interests without meeting the criteria for paraphiliac disorder. Dozens of paraphilias have been described, and some of them are
only marginally represented. There can be more than one paraphiliac disorder in unhealthy persons (antisocial, sadistic, narcissistic, etc) which increases the difficulty of
treatment procedures. Certain paraphilias, such as pedophilia, are specific incriminating acts which most often result in jail sentences, stigmatization of perpetrators and their
victims, as well as lifetime registration as a sexual offender. Pedophilia, alternatively marked as the pedophiliac disorder is a psychosexual defect most often seen in adults, who are obsessed with sexual fantasies or efforts to enter sexual relations with children of the same or of the opposite sex. It is a very complex disorder, which demands sociological, criminological, and particularly psychopathological approaches that would systematically research symptoms, nature, and factors (hereditary, organic, and social) of pathological states and processes in the mental life of these persons.
Key words: pedophilia, causes of pedophilia, prevalence, Internet pedophilia, traumas and needs, a perspective of treatment
Pedophilia is a form of paraphilias, characterized by constant and intensive sexual fantasies, impulses and behavior that relate to children (usually under 13 years of age). This symptomatology is more expresses percentage-wise in males than in females, although it is observed that this deviancy is much more perfidious
and discrete in females. Pedophilia is present everywhere and can be found in all social classes, regardless of wealth, education, or religion. Some pedophiles are attracted only by boys, other only by girls, and there is a third category of these persons who are attracted to both genders. Some pedophiles show a subtle
affinity to certain physical attributes (age, build, face, hair, voice, etc.), while the others are less “picky”. These people, with personality structure disorder, are usually known to a child. They can be members of an immediate or wider family or persons with authority, like teachers and coaches. Some of them show incestuous tendencies and are attracted by children from their own families. This is a generally unspoken topic. Many family members avoid bringing that to the surface and try to handle the problem themselves because otherwise they will face public judgment and carry a social stigma. In that case, child-victim is exposed to additional risks for mental and physical health.
Background:
Adolescents and young adults with a sexual interest in young children represent an underserved population. The needs of this group, and their implications for child sexual abuse prevention program development, are not well understood.
Objective:
The objective of this research is to advance knowledge about adolescents and young adults with a sexual interest in children to better inform the development of effective prevention and mental health efforts.
Participants and setting:
The sample consisted of 30 young adults, ages 18-30, from North America, South America, Europe, and Australia.
Methods:
Researchers conducted telephone interviews with participants, and asked about when their interest in children emerged, how they responded to this sexual interest, and what resources could have been helpful during this process. Participants also completed a brief, online survey. Interviews were transcribed and analyzed using Dedoose software.
Results:
Participants reported that their sexual interest in children emerged during adolescence, and as part of that process, they experienced a variety of emotions, including fear, shame, and feelings of isolation. Participants also noted the need for role models who are sexually interested in children and successfully navigating life, positive messaging, and support from families and the community.
Conclusions:
Young people with a sexual interest in children are largely hidden, vulnerable, and looking for help. Findings from this research can be used to direct the development of the prevention and mental health programs that are responsive to the needs of this community.
Individuals who are attracted to minors but have abstained from sexual offending (non-offending minor-attracted persons) are an under-researched, hard-to-reach population. The current study explored professionals’ perspectives of the barriers this population faces in seeking and receiving help and how these barriers can be reduced. Twenty professionals read an original vignette and answered a series of questions via an online survey. Using an inductive thematic analysis, the accessibility of treatment and perceived risk of disclosure emerged as the main barriers to seeking and receiving help. To reduce these barriers a number of potential solutions were suggested, including increasing publicity, educating the public, and offering enhanced training to professionals. This research should bolster future efforts to prevent child sexual abuse and contribute to strategies focused on helping non-offending minor-attracted persons manage their attraction in a pro-social way.
Work in the field of prevention of sexual crime has developed considerably over the years. However, there is still more to be done to ensure services and support continue to develop and are appropriately tailored to meet the needs of individuals concerned about their sexual interests, particularly prior to offending. This chapter explores some of the challenges and barriers to accessing support for this population, before moving on to consider some of the future directions for prevention efforts and the factors that need to be considered in light of the many complexities and sensitivities of working with this group.
The primary aim of this exploratory research was to gain information from minor-attracted persons (MAPs) about their (a) formal and informal experiences with help-seeking for minor attraction, (b) perceived barriers to seeking help for concerns about minor attraction, and (c) treatment priorities as identified by consumers of these services. A nonrandom, purposive sample of MAPs ( n = 293, 154 completed all questions) was recruited via an online survey. Results show that 75% of participants did seek formal help from a professional; however, just less than half of them found the experience to be helpful. Characteristics of helpful therapeutic encounters included nonjudgmental attitudes, knowledge about minor attraction, and viewing clients in a person-centered and holistic way. Barriers to help seeking included uncertainty about confidentiality, fear of negative reaction or judgment, difficulties finding a therapist knowledgeable about MAPs, and financial constraints. Understanding or reducing attraction to minors were common treatment goals, but participants also prioritized addressing general mental health and well-being related to depression, anxiety, loneliness, and low self-esteem. Implications for effective and ethical counseling and preventive interventions for MAPs are discussed.
Research estimates that as many as 1 in 20 children in the United Kingdom (UK) have been victims of child sexual abuse. The scale of this problem motivates prevention efforts; however, there is an apparent absence of preventative intervention for those individuals who are concerned about their sexual preference for children, including those who have not committed an offense. Due to the sensitive nature of child sexual abuse and stigma surrounding pedophilia, individuals who are concerned about their sexual interests in children are unlikely to willingly participate in research. By investigating the experiences of staff that are employed by an organization offering an anonymous helpline for people who experience sexual thoughts and behaviors toward children, this research aims to develop understanding of the needs of those individuals, in order to establish how child sexual abuse might be prevented. Semistructured interviews were conducted with five practitioners from a sexual abuse prevention organization, and thematic analysis revealed three main themes: (a) moving service users forward, (b) barriers to intervention, and (c) prevention: missing pieces. The first theme identifies ways in which practitioners may help service users to identify their problem, associated risk factors, and how they might begin to move forward. The second theme addresses certain factors that prevent service users from accessing or engaging with primary interventions. Finally, the third theme discusses the ways in which primary prevention could be built upon, by considering participants’ experiences that are shaped by their work in the field of primary intervention, and their experience of service users. This is the first time the needs of those who may benefit from primary prevention in the UK have been explored in this way; therefore, each theme is discussed in relation to primary prevention of child sexual abuse.
This meta-analytic review examined the effectiveness of psychological treatment for sex offenders by summarizing data from 43 studies (combined n = 9,454). Averaged across all studies, the sexual offence recidivism rate was lower for the treatment groups (12.3%) than the comparison groups (16.8%, 38 studies, un-weighted average). A similar pattern was found for general recidivism, although the overall rates were predictably higher (treatment 27.9%, comparison 39.2%, 30 studies). Current treatments (cognitive-behavioral, k = 13; systemic, k = 2) were associated with reductions in both sexual recidivism (from 17.4 to 9.9%) and general recidivism (from 51 to 32%). Older forms of treatment (operating prior to 1980) appeared to have little effect. Future directions for improving the quality of sex offender treatment outcome evaluations are discussed.
In this article we reflect on developments in our thinking and practice concerning youth sexual offending. We put the case that context is critical to understanding and responding to the problem, and accordingly that a social ecological model provides the most suitable conceptual and practice framework for clinical efforts with this population. We argue that, since the primary goal of clinical forensic intervention is to prevent recidivism, clinical efforts should focus on a limited number of specific individual, situational, and ecological risk and protective factors. Finally, we describe how our clinical fieldwork has led to the discovery of serious endemic problems with youth sexual violence and abuse in two different communities, and outline our approach to designing, implementing and evaluating a suite of locally-tailored preventive interventions to reduce the prevalence and impact of these problems.
Purpose: We examine whether the Shifting Boundaries (SB) intervention, a primary intervention to prevent youth dating violence and sexual harassment (DV/H), is differentially effective for girls compared with boys or for youth with a history of DV/H experiences.
Methods: We randomly assigned SB to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes to receive a classroom, building, combined, or neither intervention. The SB classroom intervention included six sessions emphasizing the laws/consequences of DV/H, establishing boundaries and safe relationships. The SB schoolwide/building intervention included the use of school-based restraining
orders, greater faculty/security presence in unsafe “hot spots” mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after intervention, and 6 months after intervention.
Results: At 6 months after intervention, the SB building-level intervention was associated with significant reductions in the frequency of sexual harassment (SH) perpetration and victimization; the prevalence and frequency of sexual dating violence victimization; and the frequency of total dating violence victimization and perpetration. We also had one anomalous finding that the interventions were associated with an increase in the prevalence of SH victimization. These results were consistent for girls and boys, and those with or without a history of DV/H, with the one exception for those exposed to the SB building condition who had earlier reported perpetrating SH had a significantly lower frequency of perpetrating SH at the follow-up than those without such a history.
Conclusions: SB can provide effective universal prevention of middle school DV/H experiences, regardless of students’ prior exposure histories, and for boys and girls.
Standardized family-based interventions are the most effective way of preventing or treating adolescent substance abuse and delinquency. This paper first reviews the incidence of adolescent substance abuse worldwide emphasizing gender and causes by etiological risk and protective factors. New epigenetic research is included suggesting that nurturing parenting significantly prevents the phenotypic expression of inherited genetic diseases including substance abuse. Evidence-based family interventions are reviewed including family change theories behind their success, principles and types of family-based interventions, research results, cultural adaptation steps for ethnic and international translation, and dissemination issues. The author's Strengthening Family Program is used as an example of how these principles of effective prevention and cultural adaptation can result in highly effective prevention programs not only for substance abuse, but for other impulse control disorders as well. The conclusions include recommendations for more use of computer technologies to cut the high cost of family interventions relative to youth-only prevention programs and increase the public health impact of evidence-based prevention programs. The paper recommends that to reduce health care costs these family-based approaches should be applied to the prevention and treatment of other impulse control disorders such as obesity and type 2 diabetes, sexually transmitted diseases, and delinquency.
Introduction:
Sexual interest toward prepubescents and pubescents (pedophilia and hebephilia) constitutes a major risk factor for child sexual abuse (CSA) and viewing of child abusive images, i.e., child pornography offenses (CPO). Most child sexual exploitation involving CSA and CPO are undetected and unprosecuted in the "Dunkelfeld" (German: "dark field").
Aim:
This study assesses a treatment program to enhance behavioral control and reduce associated dynamic risk factors (DRF) in self-motivated pedophiles/hebephiles in the Dunkelfeld.
Methods:
Between 2005 and 2011, 319 undetected help-seeking pedophiles and hebephiles expressed interest in taking part in an anonymous and confidential 1-year-treatment program using broad cognitive behavioral methodology in the Prevention Project Dunkelfeld. Therapy was assessed using nonrandomized waiting list control design (n=53 treated group [TG]; n=22 untreated control group [CG]).
Main outcome measures:
Self-reported pre-/posttreatment DRF changes were assessed and compared with CG. Offending behavior characteristics were also assessed via self-reporting.
Results:
No pre-/postassessment changes occurred in the control group. Emotional deficits and offense-supportive cognitions decreased in the TG; posttherapy sexual self-regulation increased. Treatment-related changes were distributed unequally across offender groups. None of the offending behavior reported for the TG was identified as such by the legal authorities. However, five of 25 CSA offenders and 29 of 32 CPO offenders reported ongoing behaviors under therapy.
Conclusions:
Therapy for pedophiles/hebephiles in the Dunkelfeld can alter child sexual offending DRF and reduce-related behaviors. Unidentified, unlawful child sexual exploitative behaviors are more prevalent in this population than in officially reported recidivism. Further research into factors predictive of problematic sexual behaviors in the Dunkelfeld is warranted.
Despite evidence globally of the heavy HIV burden among sex workers (SWs) as well as other poor health outcomes, including violence, SWs are often excluded from accessing voluntary, confidential and non-coercive health services, including HIV prevention, treatment, care and support. This study therefore assessed the prevalence and association with regular HIV testing among street- and off-street SWs in Vancouver, Canada. Cross-sectional baseline data were used from a longitudinal cohort known as "An Evaluation of Sex Worker's Health Access" (AESHA; January 2010-July 2012). This cohort included youth and adult SWs (aged 14+ years). We used multivariable logistic regression to assess the relationship between explanatory variables and having a recent HIV test (in the last year). Of the 435 seronegative SWs included, 67.1% reported having a recent HIV test. In multivariable logistic regression analysis, having a recent HIV test remained significantly independently associated with elevated odds of inconsistent condom use with clients [adjusted (multivariable) odds ratios, AOR: 2.59, 95% confidence intervals [95% CIs]: 1.17-5.78], injecting drugs (AOR: 2.33, 95% CIs: 1.17-4.18) and contact with a mobile HIV prevention programme (AOR: 1.76, 95% CIs: 1.09-2.84) within the last six months. Reduced odds of having a recent HIV test was also significantly associated with being a migrant/new immigrant to Canada (AOR: 0.33, 95% CIs: 0.19-0.56) and having a language barrier to health care access (AOR: 0.26, 95% CIs: 0.09-0.73). Our results highlight successes of reaching SWs at high risk of HIV through drug and sexual pathways. To maximize the effectiveness of including HIV testing as part of comprehensive HIV prevention and care to SWs, increased mobile outreach and safer-environment interventions that facilitate access to voluntary, confidential and non-coercive HIV testing remain a critical priority, in addition to culturally safe services with language support.
Stigmatization restricts people's opportunities in life and has severe consequences on mental health and psychological well-being. This article focuses on stigmatization research on pedophilia. Based on an extensive literature search, it reviews studies that have empirically determined lay theories, stereotypes, prejudices, and discrimination against people with pedophilia, as well as the effect of stigma on this group. The review reveals a scarcity of empirical studies on the subject (11). Although the majority of studies give at least an indication that stigma against people with pedophilia is highly prevalent, we also identified severe methodological limitations and a lack of a unifying and systematic research agenda. We discuss the need for more theory-driven, rigorous, and representative empirical studies and propose perspectives and requirements for the scientific study of stigma against people with pedophilia.
The current meta-analysis compared the characteristics of online child pornography-only offenders, typical (offline) sex offenders against children, and offenders with both child pornography and contact sex offences against children (mixed). Based on 30 unique samples (comparison ns ranging from 98 to 2,702), the meta-analysis found key differences between groups. Offenders who committed contact sex offences were more likely to have access to children than those with only child pornography offences. In contrast, offenders who used the internet to commit sexual offences had greater access to the internet than those with contact sex offenders. Differences between the groups, however, were not limited to differential opportunities. Sex offenders against children and mixed offenders were found to score higher on indicators of antisociality than online child pornography offenders (CPOs). CPOs were also more likely to have psychological barriers to sexual offending than sex offenders against children and mixed offenders (e.g., greater victim empathy). Mixed offenders were found to be the most pedophilic, even more than CPOs. The findings suggest that offenders who restricted their offending behavior to online child pornography offences were different from mixed offenders and offline sex offenders against children, and that mixed offenders were a particularly high risk group.
The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. This study aims to support the SC-CPCRN's goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute's evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
The article reports a meta-analysis on controlled outcome evaluations of sexual offender treatment. From 2,039 documents published in five languages, 69 studies containing 80 independent comparisons between treated and untreated offenders fulfilled stepwise eligibility criteria (total N = 22,181). Despite a wide range of positive and negative effect sizes, the majority confirmed the benefits of treatment. Treated offenders showed 6 percentage points or 37% less sexual recidivism than controls. Effects for violent and general recidivism were in a similar range. Organic treatments (surgical castration and hormonal medication) showed larger effects than psychosocial interventions. However, this difference was partially confounded with methodological and offender variables. Among psychological programs, cognitive–behavioral approaches revealed the most robust effect. Nonbehavioral treatments did not demonstrate a significant impact. There was no outcome difference between randomized and other designs, however, group equivalence was associated with slightly larger effects. Various other moderators had a stronger impact on effect size (e.g., small sample size, quality of outcome reporting, program completion vs. dropout, age homogeneity, outpatient treatment, and authors affiliation with the program). More differentiated, high-quality evaluations are needed to clarify: What works for whom under which circumstances?
To evaluate the long-term efficacy of a school-based approach to drug abuse prevention.
Randomized trial involving 56 public schools that received the prevention program with annual provider training workshops and ongoing consultation, the prevention program with videotaped training and no consultation, or "treatment as usual" (ie, controls). Follow-up data were collected 6 years after baseline using school, telephone, and mailed surveys.
A total of 3597 predominantly white, 12th-grade students who represented 60.41% of the initial seventh-grade sample.
Consisted of 15 classes in seventh grade, 10 booster sessions in eighth grade, and five booster sessions in ninth grade, and taught general "life skills" and skills for resisting social influences to use drugs.
Six tobacco, alcohol, and marijuana use self-report scales were recorded to create nine dichotomous drug use outcome variables and eight polydrug use variables.
Significant reductions in both drug and polydrug use were found for the two groups that received the prevention program relative to controls. The strongest effects were produced for individuals who received a reasonably complete version of the intervention--there were up to 44% fewer drug users and 66% fewer polydrug (tobacco, alcohol, and marijuana) users.
Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.
The current epidemic of violence in America threatens not only our physical health but also the integrity of basic social institutions such as the family, the communities in which we live, and our health care system. Public health brings a new vision of how Americans can work together to prevent violence. This new vision places emphasis on preventing violence before it occurs, making science integral to identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained effort at all levels of society will be required to successfully address this complex and deeply rooted problem.
PIP
Violence is a major contribution to premature death, disability, and injury. In America, there is an epidemic of violence, which threatens not only the physical health, but also the integrity of basic social institutions such as the family, the communities, and the health care system of the public. In this paper, the new vision for violence prevention embodied in the public health approach is discussed. It shifts the focus of the society in the way violence is addressed, from reacting to the problem to changing the social, behavioral, and environmental factors that cause violence. The emphasis is on preventing violence before it occurs, making science integral in identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained and coordinated effort to prevent violence will be necessary at all levels of society to address this complex and deeply rooted problem.
This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation.
This meta-analytic review examined the effectiveness of psychological treatment for sex offenders by summarizing data from 43 studies (combined n = 9,454). Averaged across all studies, the sexual offence recidivism rate was lower for the treatment groups (12.3%) than the comparison groups (16.8%, 38 studies, unweighted average). A similar pattern was found for general recidivism, although the overall rates were predictably higher (treatment 27.9%, comparison 39.2%, 30 studies). Current treatments (cognitive-behavioral, k = 13; systemic, k = 2) were associated with reductions in both sexual recidivism (from 17.4 to 9.9%) and general recidivism (from 51 to 32%). Older forms of treatment (operating prior to 1980) appeared to have little effect. Future directions for improving the quality of sex offender treatment outcome evaluations are discussed.
This study determined 4-year postintervention effects of Safe Dates on dating violence, booster effects, and moderators of the program effects.
We gathered baseline data in 10 schools that were randomly allocated to a treatment condition. We collected follow-up data 1 month after the program and then yearly thereafter for 4 years. Between the 2- and 3-year follow-ups, a randomly selected half of treatment adolescents received a booster.
Compared with controls, adolescents receiving Safe Dates reported significantly less physical, serious physical, and sexual dating violence perpetration and victimization 4 years after the program. The booster did not improve the effectiveness of Safe Dates.
Safe Dates shows promise for preventing dating violence but the booster should not be used.
How to communicate risk of recidivism in correctional and forensic contexts has been a subject of scholarly discussion for two decades. This emerging literature, however, is sparse compared with studies on the assessment of risk for violent and offending behavior. In this special issue of Behavioral Sciences and the Law, we have gathered together empirical and review papers exemplifying promising directions and methodologies. We begin with a review of the state of the field, and lessons that can be drawn from research into medical risk assessment and risk communication, finding that many of the same principles apply to the forensic context. How risks are framed, and how numerate assessors are, affects how risk information is understood and applied. We discuss the existing research bearing on these issues, as well as the conceptual, practical, empirical, and legal implications of communicating risk using numerical or categorical risk terms. Along with the seven articles in this volume, we suggest directions for future research on measuring and communicating change, understanding and managing the statistical literacy of those who use and communicate risk assessments, and developing a theoretical framework for forensic risk communication research. We hope this volume will help integrate and invigorate research into forensic risk communication. Copyright © 2015 John Wiley & Sons, Ltd.
Copyright © 2015 John Wiley & Sons, Ltd.
Available free until 22nd Jan 2015 from: http://authors.elsevier.com/a/1Q89R7bKBW2jo
The paper provides a review of some of the thoughts, ideas, and opinions that pervade the public health literature concerning how to classify or conceptualise violence. It is argued that violence transcends classic distinctions between communicable and non-communicable diseases, distinguishes itself from the discipline of injury control, and is influenced by wider, social determinants. Through a discussion of these varied perspectives it is concluded that a fourth revolution in public health is needed – a ‘change in scope’ revolution – that recognizes the influence of social justice, economics, and globalization in the aetiology of premature death and ill health, into which violence fits. However, rather than be shackled by debates of definition or classification, it is important that public health acknowledges the role it can play in preventing violence through policy and practice, and takes unified action.
Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene.
This paper argues that we should cease treating sexual offending as a problem best dealt with by psychology, medicine, or law. Sexual offending, like mental illness, alcoholism, or drug addiction, is a public health problem, one that is everyone's business. The paper first considers the traditional levels of prevention in public health: primary, secondary, and tertiary. The argument is made that most of our efforts have been directed to the tertiary level where they are least likely to be effective. Applications of the general public health model to sexual violence are considered. These include epidemiology, risk factor research, program evaluation, and dissemination of information on what works. Various methods for informing and educating the public about sexual violence are proposed. The paper concludes with suggestions on how harm can be minimised through the use of a public health approach.
One hundred twenty-nine outpatient child molesters (91 nonfamilial and 38 father/daughter offenders) were assessed and interviewed regarding various aspects of their deviant sexuality. Of our total sample, 29% reported having deviant fantasies prior to age 20, and this was most pronounced (41.1%) among those who molested the sons of other people. Fourteen percent of the nonfamilial offenders against boys, 11.8% of the nonfamilial offenders against girls, and 7.9% of the incest offenders had one or more paraphilia additional to their index offense; only three of the total sample reported more than two additional paraphilias. These data differ from those reported earlier by Abel and his colleagues (1985) and by Freund (1990). The results are discussed in terms of these discrepancies.
Perpetration of physical, sexual, and psychological abuse is prevalent in adolescent relationships. One strategy for reducing such violence is to increase the likelihood that youth will intervene when they see peers engaging in disrespectful and abusive behaviors.
This 12-month follow-up of a cluster RCT examined the longer-term effectiveness of Coaching Boys Into Men, a dating violence prevention program targeting high school male athletes.
This cluster RCT was conducted from 2009 to 2011. The unit of randomization was the school, and the unit of analysis was the athlete. Data were analyzed in 2012.
Participants were male athletes in Grades 9-11 (N=1513) participating in athletics in 16 high schools.
The intervention consisted of training athletic coaches to integrate violence prevention messages into coaching activities through brief, weekly, scripted discussions with athletes.
Primary outcomes were intentions to intervene, recognition of abusive behaviors, and gender-equitable attitudes. Secondary outcomes included bystander behaviors and abuse perpetration. Intervention effects were expressed as adjusted mean between-arm differences in changes in outcomes over time, estimated via regression models for clustered, longitudinal data.
Perpetration of dating violence in the past 3 months was less prevalent among intervention athletes relative to control athletes, resulting in an estimated intervention effect of -0.15 (95% CI=-0.27, -0.03). Intervention athletes also reported lower levels of negative bystander behaviors (i.e., laughing and going along with peers' abusive behaviors) compared to controls (-0.41, 95% CI=-0.72, -0.10). No differences were observed in intentions to intervene (0.04, 95% CI=-0.07, 0.16); gender-equitable attitudes (-0.04, 95% CI=-0.11, 0.04); recognition of abusive behaviors (-0.03, 95% CI=-0.15, 0.09); or positive bystander behaviors (0.04, 95% CI=-0.11, 0.19).
This school athletics-based dating violence prevention program is a promising approach to reduce perpetration and negative bystander behaviors that condone dating violence among male athletes.
This study is registered at www.clinicaltrials.gov NCTO1367704.
A public health approach to the violence epidemic in the United-States describes the dimensions and root causes of the problem with violence in the United States. After defining the problem and who is affected, the paper criticizes the dominant policy and describes an alternative, community based, public health approach to violence prevention that the authors are currently helping to implement in Northern California.
The Berlin Prevention Project Dunkelfeld (PPD) aims to prevent child sexual abuse (CSA) by targeting men who fear they may sexually abuse children, and who seek help without being mandated to do so. This article aims to demonstrate that a pedophilic or hebephilic sexual preference is very common among these men, to show how these men can be reached, and to document their determination to find help. The target group was informed of the project and encouraged to respond via a media campaign. A telephone screening was conducted over the first 18 months. Of the 286 who completed the screening (60.1% of the respondents), 84.3% (N = 241) were interviewed by a clinician. Of the interviewees, 57.7% (N = 139) and 27.8% (N = 67) expressed a sexual preference for prepubescent and pubescent minors, respectively, and 10.8% (N = 26) for mature adults. The remaining 3.7% (N = 9) could not be reliably categorized. As (potential) child molesters with a respective sexual preference can be reached via a media campaign, efforts to prevent CSA ought to be expanded to target this group.
Describes a program for dealing with convicted sex offenders. This program includes incarceration and treatment of high risk offenders in maximum and medium security institutions, movement of successfully treated offenders and lower risk offenders to a less extensive treatment program in a minimum security jail, and release to the community where offenders are reassessed and treated, while they begin supervised implementation of a relapse prevention plan. The evidence suggests that this overall approach is not only effective in reducing recidivism, but also cost-effective in reducing the expense to society of dealing with reoffenders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse, which, although somewhat efficacious, did not reduce HIV transmission. Biomedical prevention strategies reduce the incidence of HIV infection. Delivery of barrier and biomedical interventions with coordinated behavioural and structural strategies could optimise the effectiveness of prevention. Modelling suggests that, with sufficient coverage, available interventions are sufficient to avert at least a quarter of new HIV infections in MSM in diverse countries. Scale-up of HIV prevention programmes for MSM is difficult because of homophobia and bias, suboptimum access to HIV testing and care, and financial constraints.
This paper presents the public health approach to the prevention of sexual violence. The public health approach addresses primary, secondary, and tertiary levels of prevention. An explanation of each level of prevention is given as it relates to the area of sexual violence. Additionally, the public health approach attempts to shift the focus of prevention from potential victims to potential perpetrators. The four steps of the public health model are presented with examples of how the Centers for Disease Control and Prevention are applying this model to sexual violence prevention.
Ottawa Public Health in partnership with health staff from the municipality of KEEA (Komenda, Edina, Eguafo, Abrem) in Ghana engaged in a city-to-city partnership to adapt, implement, and evaluate an evidence-based hand hygiene public health initiative in elementary schools in Ghana. All 4 participating schools gained the necessary resources to carry out proper hand hygiene practice, and hand hygiene practice improved. Furthermore, pupils were more likely to wash hands after using the toilets and teachers were better equipped to be good role models. Providing resources to schools was key to the success of the implementation. This partnership gave health and education workers in Ghana the tools, knowledge, and confidence to implement a simple, evidence-based, hand hygiene program. One other remarkable outcome is that school children were the initiators of a behavior change in their community.
Measurement of sexual behaviors is typically reliant on retrospective self-reports of behaviors. Historically, self-reported sexual behavior data were primarily collected through face-to-face interviews or paper-and-pencil questionnaires, as these were the only modes of inquiry available. In recent decades, technological innovations such as telephones, computers, and the Internet have expanded the self-report inquiry modes available. The addition of these new inquiry modes further complicates the ability of sex researchers to evaluate the quality of research results and compare findings across studies. Self-report sexual behavior data are vulnerable to participation biases, as well as to sources of bias in individual responses, such as recollection and social desirability bias. This is true regardless of the inquiry mode being used, but some modes may be more vulnerable to bias than others. This review examines the available research regarding self-report sexual behavior research, inquiry mode, and relative bias across modes. The review also provides recommendations for advancing the current understanding of inquiry mode effects within sexual behavior research. Specifically, by shifting the focus away from evaluating specific modes of inquiry toward examination of factors common across all modes, researchers will be better able to interpret existing research and improve the designs of future studies as well.
To investigate the effects of two Internet-based weight loss interventions on physical activity (PA) and dietary behaviors using two approaches for computing combined behavior change.
Participants were 352 overweight/obese women and men completing 12-month interventions in San Diego, California during 2002-2007. Moderate-to-vigorous PA (MVPA) and sedentary time were measured with accelerometers, and dietary fat and fruit and vegetable intake were assessed with food frequency questionnaires. Longitudinal analyses tested the effect of the intervention on combined health behavior change quantified using a standardized residualized change index (SRCI) and a risk factor change index (RFCI).
At baseline, participants engaged in an average of 153 min/week of MVPA and 525 min/day of sedentary time, and consumed 37% of calories from fat and <3 fruits and vegetables per day. The interventions had a significant effect on combined behavior change as measured with each approach (p<0.001). The intervention effect was larger (p<0.001) when evaluated using the SRCI (standardized regression coefficient [Beta]=0.30) than the RFCI (β=-0.18).
Interventions that target both PA and dietary behaviors appear effective. The SRCI was more sensitive for evaluating the intervention, but the RFCI may be easier to use for communicating public health significance.
Little is known about men who have not yet committed child sexual abuse but may be at risk of doing so (potential offenders) and the factors that distinguish these men from undetected child sexual abuse offenders with a sexual interest in children (Dunkelfeld offenders). The present study describes and compares potential and Dunkelfeld offenders, which can be viewed as ideal target groups for (primary) prevention efforts with respect to child sexual abuse. Also, this study seeks to demonstrate the feasibility of using a telephone screening procedure to conduct research with these groups. Using a computer assisted telephone interview (CATI), data on demographics, mental health, sexuality, criminal history, and victim characteristics were collected from respondents in a nation-wide media campaign, which informed potential (re-)offenders of child sexual abuse of a research and treatment project. Many participants reported recurrent sexual fantasies involving minors, as well as related distress, suggesting a high prevalence of pedophilia and hebephilia. More than half feared they would sexually abuse a minor, and Dunkelfeld offenders reported 3.2 victims on average. Group comparisons revealed that Dunkelfeld offenders were, for example, more likely to perceive themselves being at risk of offending, compared to potential offenders. The results suggest that targeting potential and Dunkelfeld offenders could prove a worthwhile approach in the prevention of child sexual abuse.
Violence is exacting an increasingly heavy toll on individuals across the country, causing a marked rise in fear and frustration. However, historical attempts to address violence have been both episodic and inconsistent. There has not been a comprehensive and coordinated, prevention-oriented approach. Many law enforcement experts now agree that violence must be met with solutions from disciplines other than law enforcement, those of public health included. These experts acknowledge that social conditions such as family stability, education, and other societal institutions directly affect the behavior of juveniles and thereby the safety of communities. No single strategy, institution, or discipline can create the changes needed to reduce violence in America. Preventing violence demands not only a long-term commitment but a comprehensive set of strategies and new partnerships. These combined efforts must focus on prevention and not solely on aggressive responses to violence.