5 Steps that institutions can take to protect children

We have been seeing in the media, more and more stories about the abuse of children involved with various institutions.  A recent story tells how the Jehova's Witnesses covered up abuse. In Australia, there has been a Royal Commission looking into institutional abuse. It seems each  chapter of their work reveals more breadth and depth of abuse.

In the United Kingdom, there has been the Rotherham story where 1400 children have been exploited. Authorities failed to act.

The reality is that children typically do not disclose abuse and when they do, they are telling the truth the vast majority of the time - we need to listen. So what can institutions do to better manage - here are 5 thoughts:

The long term impacts of child abuse in institutions is well documented. One only need to look at the impact of the Residential Schools in Canada. One recent story shows how one community is still tackling the impact of the St. Michael's school in Alert Bay, B.C. 

Institutions owe a duty to those in their care.

60 year old man in a sexual relationship not abusive Italian court says

In a rather stunning verdict, the Italian Supreme Court has overturned the conviction of a 60 year social service worker, Pietrio Lamberti,  for having a sexual relationship with an 11 year old girl. The reasons are reported to be that the lower courts failed to consider the amorous relationship and the consensus between the two. In some fashion, this is seen as justifying the relationship.

This seems astounding for several reasons. The first seems to be that many victims of sexual abuse can feel good in some way about the relationship. It can make them feel special and they may receive treats that others do not. In this case, the girl came from a poor family.

Even more important, is an 11 year old really capable of consenting to sex with a 60 year old? There is little reason to believe that such consent could be valid. The age difference creates a power differential. A child of this age (and she is clearly a child at that age) cannot really appreciate what she is consenting to.

In rather classic fashion, the social worker is reported to have gained the trust of the family. This is grooming behavior.

In this case, the court appears to have failed to understand the true nature of child sexual abuse. They have been hoodwinked by the kind of rationale that pedophiles create. How unfortunate. 

What supports sexual abuse disclosure?

In 2011, I had the privilege of delivering the annual lecture sponsored by the Tulir Centre for the Prevention and Healing of Child Sexual Abuse. They are located in Chennai, India. I was speaking on the sexual abuse by a sibling or juvenile. An individual in the audience found it hard to believe that the majority of victims are not disclosing the abuse almost immediately after it happens. I was reminded of this upon reading a newly published study in the Journal of Interpersonal Violence. McElvaney, Greene & Hogan have raised a number of very fascinating points. The article is well worth a read including their literature review in the introduction.

These researchers helped to identify that there may be a difference in the data from studies that have been done on a prosecution sample (where there has been disclosure in some way) and in studies where there has not been the involvement of the criminal justice system. They note that in research studies, there is a substantial group who has never told prior to being asked in the study - this ranged from 19% up to 47%. Silence is real.

The longer the delay in telling, the harder it may be to seek help. Further, given the link between child sexual abuse and subsequent traumatization through sexual assault and abuse, it may be even harder as trauma builds upon trauma.  There are many barriers to disclosure which the authors identify including shame, guilt, the risk to the family or the perpetrator and fear of reactions by others. I was particularly interested in the notion of the victim needed to weigh the consequences of a disclosure creating a pressure cooker effect - the wish to tell and the wish to keep it secret. This is a wonderful insight that serves as a useful reminder that disclosure is often an extremely challenging decision.

These authors found 5 themes from they qualitative research with both victims and parents:

1. The fear of not being believed although those fears often turned out to be unfounded once the disclosure was made;
2. Being asked is a way in which disclosure occurs.There were also those in the study who felt that someone (an adult) must have known it was happening;
3. Shame and Self Blame was another theme;
4. Fear and concerns for self and others - for example the fear that a disclosure would break up the family or that the victim would be unsafe or get int trouble; and
5. Peer influence in that first disclosures often happened to a peer.

There is a need to be aware of these barriers when working with those who may have been abused. As the researchers noted, many parents were "incredulous" when the child disclosed. It was not something that was meant to happen in their own family. 

A child who has yet to disclose may have some or all of these barriers in place - each one of them being quite powerful in and of themselves. Imagine the impact of several at once.

In my own work, I have seen time and time again, various disclosures simply because I have asked. This research affirms that. 

An already hurt and wounded child does not want to spread the pain - hurt the family; cause a family member to be gone; create more vulnerability as well as the fear of retaliation. One feature that may be useful in creating disclosure, beyond creating safety for the child, is to ensure that the perpetrator does not hurt others. Thus, disclosure can protect siblings or other children. This seemed to matter. But, of course, little will occur if the child believes that disclosure will create a further lack of safety.

Reference:

McElvaney, R., Greene, S. & Hogan, D. (2013). To tell or not to tell? Factors influencing young people's informal disclosures of child sexual abuse. Journal of Interpersonal Violence, published online 27 November 2013. http://dx.doi.org//10.1177/0886260513506281 

Jimmy Savile and Jerry Sandusky - Hiding in Plain View

Social workers and others who work with children around the world, have much to learn from these two high profile sexual abuse case. The material published in the UK today about the breadth and extent of the sexual abuse committed by Savile farnkly boggles the mind. As the CBC reports today:

Detectives said the scale of Savile's sex abuse was "unprecedented in the U.K." They have recorded 214 offences allegedly committed by Savile between 1955 and 2009, including 34 rapes, on victims aged 8 to 47. In all, 450 people have come forward with information about abuse by the late TV presenter.

Jimmy Savile

The details that are coming out show that the range of sexual behaviors and the settings in which Savile committed his alleged crimes includes children who were pre pubescent and teenagers. He did it under the cover of his fame and charity work. As one police officer has noted, he hid in plain view. The Guardian newspaper in the UK offers insight not only into the staggering size of Savile's crimes but also the utter failing of a system that refused to believe, deal with, or collate the data that was available from victims who had come forward. The system failed those who were willing to seek justice - a system that the report clearly shows bent badly in the wind that blew from the magnitude of Savile's deemed importance.

Like Savile, Sandusky had a huge public reputation which appears to have allowed him to hide as well. The power that both men possessed made coming forward with the allegations incredibly challenging. It would be a brave victim indeed who could challenge the reputation of these powerful men. Bear in mind that sexual abusers have an uncanny capacity to choose victims who are weak, vulnerable and desperate for the attention of the powerful.

These two cases are not unique but rather help us to see, yet again, the role that power plays. We have seen hundreds of victims in the cases of priests in various churches and also in such revered organizations as the Boy Scouts.

Sexual abusers take full advantage of the power of role - Savile as the music industry icon; Sandusky as the winning coach; the priest as the sacred leader; the Boy Scout leader as the person to be trusted as a guide in life. These are all very socially supported and revered positions.

Social workers need to be very mindful of the ability of the predator to use position. The sexual abuser does it time and again. When the social worker hears the stories, we need to be open to the telling. Sexual abusers in these positions count on their reputation and the notion that those speaking against them won't be believed.

The rate of false allegations is small.

I like some key points from Dr. D.L. Reed:

* A substantial proportion of sexually abused children are quite reluctant to disclose their abuse; many are ambivalent about disclosing; many delay disclosing•Disclosure of sexual abuse is typically a “dynamic process” not a “one-time event.” Consequently, confirmed victims often make inconsistent statements•When CSA victims are interviewed only once, they often minimize the extent of their abuse; and some deny it altogether•When children’s abuse allegations include fantasy elements, this does not necessarily mean that they weren’t abused 

 The point is that disclosure occurs in a variety of ways, over time and often with a great deal of shame and guilt (the victim may well think that the abuse is their fault). Victims may let slip little details by accident at the start or as a way to test how people will react. We have a need to just listen and not judge.

There are many more perpetrators out there that have yet to be discovered. Social workers are key in hearing these stories as are parents, teachers, police officers and many others with whom a child has contact. A child alleging it occurred with someone powerful should not deter us hearing them.

Jimmy Savile - Power and Domination

If you follow stories regarding sexual abuse, you would be had pressed to have missed the one about Jimmy Savile. He is the former BBC music icon who is now thought of as one of the most significant serial sexual abuser of our time. It has been reported that his victims may number 300 or more. It is a staggering story but one where prestige, money and power are at the centre.

What struck me is the common thread in so many sexual abuse cases - those who saw that something was wrong failed to act. Because of this, there were more victims. The Guardian newspaper in the UK notes that:

Doctors and managers at Stoke Mandeville hospital were afraid to challenge Jimmy Savile over the free access he enjoyed to wards, out of fear that he would take his fundraising millions elsewhere, a former director of nursing has said, as fresh claims emerged of abuse at the hospital and elsewhere.

It is gaining a position of power that allows abusers to get away with what they do. It gives them access to victims; it creates room for them to groom victims and they do so with the immunity that comes when others fail to act. We saw that in the Jerry Sandusky case in the United States.

As in the Sandusky case, there were a few occasions when someone would tell, but they lacked the power to force action. Like Sandusky, those who could have acted with the information that they were given failed to do so. The Telegraph reported

Jimmy Savile's former director on Jim'll Fix It reveals he saw the presenter having sex with a 16-year-old girl in his dressing room and informed BBC officials who 'did nothing'.

The story adds

David Nicolson, 67, said he reported the incident to his bosses at the corporation in 1988 but was rebuffed and simply told: "That's Jimmy".
He told The Sun newspaper: “I was revolted by his behaviour. They just shrugged it off, saying, ‘Yeah, yeah — that’s the way it goes’.”
“Everyone knew what was going on. That includes senior BBC people — chiefs at the highest levels. 

These are illustrations that organizations become invested in the image, prestige and money that comes with characters such Jimmy Savile and Jerry Sandusky. They become wilfully blind to the reality of what is going on and fail to act ethically. Such organizations need to be held accountable, as has happened with Penn State University in the Sandusky case. Will the BBC also be held accountable? Let's keep a close eye.

Additional Note:

ToledeBlade.com reports that there are further charges in the Sandusky case against those who covered up his behaviour. Former Penn State University President Graham Spanier was charged related to a conspiracy of silence. The report notes:

“This was not a mistake by these men. It was not an oversight. It was not misjudgment on their part,” Ms. Kelly (Attorney General) said. “This was a conspiracy of silence by top officials, working to actively conceal the truth, with total disregard for the children who were Sandusky’s victims.”

Mr. Spanier is, of course, innocent until proven otherwise. This step does send a message that covering up sexual abuse by another brings its own accountability.

You may also find this story on the role of silence to be quite relevant.

Sexual assault, sexual abuse -- life long stories

It is hard to read the papers or professional journals these days without being faced with the legacies that arise from sexual abuse and sexual assault. As I write this entry, the media are covering an audio statement from convicted sexual offender Jerry Sandusky. In it, he claims his ongoing innocence. Given the number of convictions, it is hard to accept his protestations that he has been wrongly convicted.

The Sandusky story is more about the failure of an institution to protect. It is certainly not the only one. But another such story is receiving widespread coverage. The Los Angeles Times carrying extensive coverage on the list of names of child abusers that the Boy Scouts of America is alleged to have improperly protected. The stories suggest that the organization simply failed to ensure that those with known records or those whose sexual abuse activities became known to the organization were properly reported, or in some cases, kept away from children.

Research being released today shows that sexual assault and rape has long term implications for the victims. These impacts are across many areas of functioning. The report on the research published by Science Daily notes that the research

shows that female victims suffer from a wide spectrum of debilitating effects that may often go unnoticed or undiagnosed...

"These findings document that victims of sexual assault, and even victims of attempted sexual assault, suffer psychological and social costs more far ranging than previously suspected," says Perilloux, who earned her Ph.D. at The University of Texas at Austin in 2011. 

There is no reason to believe that victims of sexual abuse will be any less affected.

The public may grow weary of the ever growing list of organizations that have failed to protect children. The challenge is more than that, however. It is about the ability of the public to believe in the value of societal institutions - to see their inherent worth. As more and more of them are dragged into the public eye in this way, the growing distrust attacks the credibility of institutions in general. Penn State, churches, Boy Scouts in Canada and the United States would have been seen as trustworthy in the past. The public must now wonder - who next? Child protection organizations  do not escape this scrutiny when stories of their failures come out, particularly when it results in the death or serious harm of a child.

Maybe abstinence sex education is harmful

There has been a movement in the religious right to push teenagers to commit to sexual abstinence. Per se, that does not seem like a negative thing. Trying to ensure that teenagers do not find themselves in unwanted parenthood or having to face decisions about what to do with an unwanted pregnancy seem like worthy goals.

Regrettably, that same movement would have abstinence education replace other forms of sexual education. I got to think about this after two recent experiences. The first was reading the 2005 book by Lisa Aronson Fontes, Child abuse and culture. She made reference to a doctoral dissertation by McDonald in 2004 which noted that most sex education occurs in adolescence which is after most victims of sexual abuse have been victimized. Fontes cogently points out that this further shames the victim who did not engage in sexual behavior by choice – but by coercion and force. What then are they to make of statements that they must save themselves for marriage and commit to abstinence? They are already sexually involved because of the abuse.

The second event was meeting with the Tulir Centre for Prevention and Healing of Sexual Abuse . Located in Chennai, India they talk about how victims are often quite young and clearly before they can receive sex education. Indeed, in many cases, they are not in a position to even understand what consent is about.

Sex education that offers children and teenagers information on choices but also helps victims to separate forced sex from sex by choice can help to prevent the unwanted pregnancies. These in turn can add to the children involved in child protection systems – but so too can rapes and molestation. Sex education should add to the efforts to prevent and heal sexual abuse and trauma. It should not be a way in which victims are then re-victimized. 

Let the Sandusky convictions mean something

Throughout North America, if not in many parts of the world, the case of former Penn State coach Jerry Sandusky was followed closely. There may well have been a sigh of relief at his conviction on 45 charges. Some will think justice has been done and with Sandusky, maybe it has. But little such satisfaction should exist.

The larger question is how does a Sandusky come to exist for so long in society without intervention. His is hardly the first such case. Indeed, in the same week that Sandusky was convicted, Monseigneur Lynn was convicted in Philadelphia for assisting in the cover up of abuse by priests in the Roman Catholic Church. CNN is reporting  that Penn State not only likely knew what he was doing but chose to not report it.

Then there are other cases in Canada such as Graham James who sexually abused minor hockey players for years. There was the Mount Cashel orphanage in Newfoundland where the Christian Brothers of Ireland physically and sexually abused boys placed in their care. Canada also saw the rampant abuse of children in the Residential Schools, with the last one closing as recently as 1996. The impact on Aboriginal families in Canada was profound. Many have yet to recover both from the abuse and the extensive fracturing of family systems.

If society truly wishes to see the end of these horrific stories of abuse, then it must be willing to open the proverbial Pandora’s Box and talk about what has and is going on. Sandusky is a high profile case in which some of his former victims found the strength to come forward and tell their story. As so often happens, their disclosures come years after the abuse occurred. Victims routinely fear disclosing because the perpetrators often occupy positions of power over the child – be it a parent who threatens harm if they disclose or a person in authority such as Sandusky whose position is such that victims typically feel they will not be believed. Many victims mistakenly feel that the abuse was somehow their own fault.

The recent report on the failure by the Boy Scouts of Canada to properly address the issues of sexual abuse perpetrators amongst their midst shows that one of the solutions is better institutional policies and responses. Without them, sexual abusers remain hidden to carry on.

Secrecy is one of the most potent tools that abusers have in order to keep abusing.  To change this, we need to allow children to tell their story with confidence that they will be believed. But we also need institutions that are willing to hear those children.

Most children who are being abused will not have their situation brought to anyone’s attention. Thus, it is up to ordinary Canadians to decide that abuse should stop and be willing to speak up when they see it. Failure to do so, is to give it tacit approval.

Cases like Sandusky serve a purpose. They create conversation and awareness. These high profile cases are rare. It is the far less visible cases that require us to act. Sandusky could get away with it because, like so many abusers, he was in a position of power. Why are we so willing to turn a blind eye to such people whether they be coaches, priests, teachers or other professionals and carers for children? The tide will start to turn against sexual abuse when we call out the powerful people in children’s lives who break the trust granted them with our children. 

As Eldridge Cleaver said, you are either part of the problem or part of the solution. Become part of the solution. As a nation, we need to raise awareness of the impact of abuse and help to create solutions. We can stop abuse by supporting families so that their children are safe. Families that need help will need to be able to find it in communities across the country. If abuse occurs outside the family, we can make it safe for our children to tell. You can do this by hearing the voices of children and making sure that a child who discloses is given a safe place to tell their story. You might be that person.

Why Sandusky matters

The conviction of former Penn state coach Sandusky matters a great deal for child protection. And no, it should not act as the basis for fear mongering that it will lead to more unwarranted apprehensions of children by child protection. Such a suggestion is based upon the notion that child protection workers are incapable of critical thinking when considering cases.

The fear might be that politicians will now try to gain political capital by making pronouncements that they will enact laws that will ensure that there will never be another Sandusky on their watch. That is politics and bad policy.

But Sandusky does matter because it sends to society some very powerful messages. To begin with, it means that the powerful who abuse can be held accountable. It means that the stories of abuse in the past can still be brought forward and the abuser convicted. It means that systems keeping these dirty little secrets should no longer be tolerated in society and that those systems should be held accountable.

Sandusky's defence lawyers argued that one of the motivations for the victims was to be able to sue and gain money. Yes, Sandusky and Penn State should be held accountable and that might mean paying money as a form of restitution. But there is no amount of money that will make up for the permanent, negative impact that sexual abuse will have on a child. There is no mistaking that such abuse creates life long changes that affect all aspects of a person's life.

There is also the good news in the conviction of Msgr. William J. Lynn. He is also in Pennsylvania. He was convicted for assisting the Catholic Church in covering up the sexual abuse by priests. This also opens the door for further accountability by institutions and systems for what goes on by those they supervise.

These convictions will not stop sexual abuse. They are public pronouncements that society is one step closer to taking strong stands that it is wrong and it will be something that society will take on stand on and send messages that it should not be tolerated. I should say will not be tolerated but I worry that there are still elements of society where it is going and the systems have yet to take the needed stand. Maybe this will crack open some of those doors.

Maybe also, these convictions will make it easier for other victims to step forward and tell their stories.

Child Sexual Abuse Disclosures

Two recent studies have offered some very important information on the issues of disclosures in child sexual abuse. The first is an Irish study which uses a qualitative grounded theory approach. This study of 22 children looked at the process of disclosure. They conclude that:

The process of confiding experiences of child sexual abuse is not linear and sequential as suggested in the early literature on child sexual abuse, but is, as Staller and Nelson-Gardell (2005) suggested, a dialogical process that is renegotiated and influenced by each experience of disclosure. (p.1169)

As they note, the disclosure process is a “stop-start” experience that occurs over the lifetime.

This research by McElvaney, Greene & Hogan, offered 3 overarching themes which will be of assistance to child protection and police investigators as well as therapists.

1.     Active Withholding – This included the subthemes of not wanting people to know; denying when asked and even experiencing difficulty saying that it did occur.  The latter is the experience of wanting to let something out but just not being able to do it.

2.     Pressure Cooker Effect – there was a build up of tension between wanting and not wanting to tell. There was also the effect of being in a state of distress about actively withholding. Telling may be the result of either an opportunity presenting itself of an unplanned disclosure.

3.     Confiding – Who to tell became important with the notion that telling needed the ability to confide in another person. Thus who was chosen was careful and might include the sharing of confidences or a need for confidentiality.

These researchers also noted that disclosure wasn’t a single event. There would be a number of occasions over the life span when the story may need to be retold or told in more or different detail. Thus, for the victim, it may well be an unfolding part of their lives.

The researchers also note in their literature review that there can be powerful influences which help us to understand why children do not disclose or may delay disclosure until later in life. These might include fear of the perpetrator or fear of the consequences of telling. Other factors might include other pressures not to tell. The child’s own guilt that they may be responsible for the abuse as well as considering the costs and benefits of telling. It is important that disclosing always comes with some level of internal and / or external costs.

The second important piece of research is by Allen & Tussey who conduct a systematic review of whether or not projective drawings can be effectively used to detect if a child has been sexually abused. Given the research above, that would be helpful if it could. There have certainly been claims from various corners that this is possible.  This research review carefully considers the literature and concludes:

The current literature review demonstrates that attempts to identify projective indicators of sexual and physical abuse in drawings completed by children are not supported by the existing evidence. (p.12)

This conclusion has very significant legal implications for mental health professionals. This really means that projective drawings should not be used and that any such use is unlikely to meet the Daubert or Frye tests in the United States. They are also not likely, in my view, to meet the Mohan test in Canada. This is:

(1) Test for Admission of Expert Evidence

[13] The test for the admission of expert evidence is well-established and undisputed on this appeal. At the first stage of the admissibility inquiry, the party seeking to tender expert evidence must establish on a balance of probabilities that the proffered evidence is: (1) relevant; (2) necessary; (3) not subject to any applicable exclusionary rule; and (4) to be advanced through the testimony of a properly qualified expert. Where these four preconditions to admissibility are satisfied, the second stage of the admissibility inquiry obliges the trial judge to engage in a contextual weighing of the probative value and significance of the proffered evidence to the case against the potential prejudice that could flow from its admission. See R. v. Abbey (2009), 97 O.R. (3d) (C.A.), leave to appeal refused (2010), 409 N.R. 397 (note); R. v. Mohan, [1994] 2 S.C.R. 9. (as cited in R. v. Boswell, 2011 ONCA 283)

While the Canadian test is different, the qualified expert must still tender evidence that is reliable. An expert relying on these projective tools may now well be more directly challenged on the credibility of the evidence when the research of Allen & Tussey is considered.

References:

Allen, B. & Tussey, C. (2012). Can projective drawings detect if a child experienced sexual or physical abuse?: A systematic review of the controlled research. Trauma, Violence & Abuse, published online first. doi: 10.1177/1524838012440339

McElvaney, R., Greene, S. & Hogan, D. (2012). Containing the secret of child sexual abuse. Journal of Interpersonal Violence, 27 (6), 1155-1175. doi: 10.1177/0886260511424503