Jail Time for Social Workers?

UK Prime Minister David Cameron is raising the notion of social workers facing jail time, perhaps up to five years, for failing to protect children from sexual abuse. A summary of the proposal is covered by  Community Care. One can easily see why this idea has come forward in the UK. Recently, there have been very high profile cases in which social workers failed to protect children from large scale abuses. A serious care review in Oxfordshire has shown that workers had knowledge that would have allowed them to protect girls.

There has also been the recent case of Rochdale where there have been multiple victims. But the story of sexual abuse in the UK has been a relentless story in the media. There is the recent conviction of former rock star Gary Glitter for sexual abuse several years ago. The Jimmy Savile case in the UK has shown a profound pattern of sexual abuse over many years with hundreds of victims. Savile, a former BBC pop music icon had access to children in many places.

In Australia, a Royal Commission continues to hear story after story of those in authority who failed to act to protect children when the information was available that something was wrong. There too, the stories seem relentless.

In the UK, the public must be weary of the ongoing media coverage of how children have not been protected by child protection - Victoria Climbie, Daniel Pelka, Baby Peter, Khyra Ishaq - and these are only the recent ones. Confidence in the ability of child protection to do their job can only be fragile given these stories. They must be asking what's wrong?

It is in this environment that Cameron raises the idea that social workers could face jail time for being wilfully blind to the risks that children are facing. It could be an idea that can gain public traction easily. Yet, is it the right thing?

Such as approach fails to ask some very key questions:

1. There are many other professionals involved such as police, doctors, health care, teachers - how will they be held accountable?
2. There are questions of caseloads - what can a worker be expected to do with caseloads of 20-30 oe even higher?
3. There is leadership - what is the role of supervisors, managers and community leaders?
4. There is training - have front line workers been given the training needed to see what is going on. Sexual abuse is a specialized area but front line workers are generalists.
5. Inter agency coordination is essential but it remains one of the key areas of difficulty.

The approach also fails to recognize how often these investigations are inconclusive. Very few cases go sexual abuse have physical evidence. It takes quite skilled investigators to work through these cases. Are we putting such skilled workers in place?

There is also the consideration that this may act to drive social workers away from child protection which is possibly the most complex and challenging form of social work. The turnover rates are high meaning that seasoned, skilled workers with this sort of specialized knowledge are not plentiful.

I can well see why Cameron (who may also be facing an election soon) can find this proposal appealing. It may not be the best way to go, however. But his concern is valid while the solution may not be.

Rape Culture, Child Protection and 50 Shades of Grey

The connection may not seem so obvious. But, let's take a moment to consider.

• We have seen a significant increase in concern about the impact of domestic violence. High profile cases in sports and the entertainment fields have heightened awareness of the problem. Several post secondary institutions have found themselves in the spotlight for failing to address the issue. A quick look at The Huffington Post illustrates the point.
• In Canada, we have watched as the question of consent in sexual relationships has derailed the career of broadcaster Jion Ghomeshi. While he still awaits trial, he has several accusers. Presently on trial in Europe is former head the IMF Dominique Strauss-Kahn for what he apparently  acknowledged to be a proclivity for rougher sex than might average man. At the heart of his story are again issues of consent.
• Sexual abuse is a high profile concern. The Roman Catholic church is burdened with working its way through years upon years of such abuse to children. In Australia at the moment, a Royal Commission is hearing about a variety of institutional sexual abuse stories. The BBC reports on the recent conviction of former rock star Gary Glitter for abuse of teenagers some years back.
• Domestic violence, including sexual assault is a significant issue in child protection matters.

At the heart of this is the question of what chidden are exposed to and what is consent. Does a woman consent to be beaten by a partner? Does a child consent to sex with an adult? Does a drunken woman consent to sex when she is too impaired to really consent? These are complex questions requiring careful consideration but those in a powerless or subordinate position are really not able to consent.

Thus, how the media plays out the issue of consent matters to society at large. 50 Shades of Grey sets up a standard for consent that suggests it might not be so voluntary and yet still acceptable. Fox News and The Atlantic have both offered thoughtful pieces on how the books and the movie are really depicting non consensual sex which must then be characterized as some level of abuse. I'm pretty sure that view will not be welcomed by the millions of followers. It's also worth noting that the BDSM community is  not welcoming this movie as exemplary of what they perceive to be voluntary, consensual activity in this sexual arena.

But if we want to create safer families and communities for children, should we not be connecting the dots between the various forces the impact how that safety is defined and created? When we make a media sensation out of non-consensual sex, and do so in a way that says this is ok, then we are enabling sexual and gender based violence. That's a problem.

Sexual Abuse and Consent: UK Judge gets it wrong

The BBC has reported:

Stuart Kerner, 44, from Kent, received an 18-month suspended sentence for two counts of sexual activity with a child by a person in a position of trust.

While the sentence seems quite low for the offence, what is most concerning is the context of the sentence. This is a case where a teacher was in a position of trust in a school. He entered into a relationship with a 16 year old student at the time that his wife miscarried with their second child. More can be found on the story on the BBC.

Stuart Kerner

The most disconcerting part of the story is, however, a view that the judge felt the child had become obsessed with Kerner and thus, groomed Kerner. In other words, the court is putting responsibility for the sexual abuse on the victim. Such a view states that the obligations of a person in authority can be modified based upon the child's behaviours. Let's expand the thought - if a child is highly oppositional, rude and perhaps even violent, then violence by a teacher in return might be permissible. But that is not allowed because we expect the adult to be able to manage their emotions, stay in control and respond in a measured and safe manner.

In this case, the failure of the adult, Kerner, to control himself is being excused because of his personal circumstances and the obsessive behaviours of the child. This is a very dangerous line of reasoning that, if applied in a variety of other criminal matters, diminishes the responsibility of the perpetrator and increases the responsibility of the victim.

This decision also missed the mark when the child is considered. This was her first sexual experience. She was 15 when the relationship appears to get underway. Her notion of relationship, sex, boundaries and even love will be highly underdeveloped. Her executive functioning is that of a 15 - 16 year old which means that she is more likely to be influenced by emotion and impulsivity than rational, long term thinking. Kerner, on the other hand, at 44 years of age, should be expected to have the maturity to work his way though both his emotions and the responsibilities of his position.

The judge has also failed to understand that Kerner was part of a system responsible for protecting children. Schools are meant to be safe places. Teachers are meant to be guardians of that safety. Kerner did not offer that. He compromised it for this student but also for all students by making a behavioural statement about what is acceptable.

I have no doubt that Kerner has paid quite a price for his behaviour. He is not able to work with children meaning that his career is in shambles. He has been subject to a great deal of public media. But these are all the result of choices that he made as an adult. There are the unspoken victims as well - his family, children as well the school, colleagues and the other children who had been aware of the relationship which would have created confusion for them.

This case matters because the courts have made a statement about responsibility that needs to be challenged. 

The impact of child abuse - greater than we might imagine

It became one of those quick national stories that flips onto the front pages for a day and is then lost. But that surely should not be the case with this one. A Canadian study soon top be published in the Canadian Medical Association Journal reports on the prevalence of child abuse and mental disorders. The results are profound.

The sample is based on just over 25,000 Canadians in 10 provinces (The 3 Northern Territories of Canada were not included).The authors looked at physical abuse, sexual abuse and exposure to intimate partner violence.  The adult responders reported on experiences before the age of 16.  Here's what they found:

1. The prevalence of any of the 3 types of child abuse was 32.1%, with physical abuse being the most common (26.1%), followed by sexual abuse (10.1%) and exposure to intimate partner violence (7.9%).
2. All child abuse types were associated with increased odds of all mental conditions (such as depression, bipolar disorder, generalized anxiety disorder, substance abuse and dependence, suicidal ideation and attempts, ADHD, Eating Disorders, PTSD, learning disabilities). 

These are quite profound numbers. It is highly probable that this data would be replicated in many Western countries that share similar family and parenting patterns. The costs (emotional, physical and financial) are astounding. Society is also paying a very large price for this through the health care, child protection, criminal justice and education systems. The strongest linkages that the authors found was between exposure to these 3 types of abuse and suicidal ideation, and attempts as well as substance abuse and dependence. 

Even more profound is the "…the least severe type of physical abuse (being slapped on the face, head or ears, or hit or spanked with something hard) showed a strong association with all mental conditions in models adjusting for sociodemographic covariates." In other words, even mild abuse has long term implications. 

This also brings us back to the spanking debate - minor abuse seems to be harmful. This research comes at a time when a study just published in the Journal of Family Psychology notes that in 73% of the cases where there was corporal punishment, the child misbehaved again within 10 minutes. That research is based on a small sample but it adds the very large body of research that tells us that spanking remains an ineffective form of parenting. The Canadian data also suggests that the impact may be long term and not what most parents would hope for - a greater risk of mental illness.

This research should help social workers and others working with families to underline why other forms of parenting and discipline are better for the child.

Richard Dawkins just has it wrong

Speaking in an interview with Times magazine, author Richard Dawkins stated:

‘Just as we don’t look back at the 18th and 19th centuries and condemn people for racism in the same way as we would condemn a modern person for racism, I look back a few decades to my childhood and see things like caning, like mild paedophilia, and can’t find it in me to condemn it by the same standards as I or anyone would today.’

At one level, it is perhaps easy to see the merits in Dawkins argument - times change and so do standards of what is and is not acceptable. Yet, he suggests that what took place 50 or 60 years ago represented such a different standard that sexual and physical abuse should be seen as indicative of the times.

Richard Dawkins

The Sovereign Independent goes on:

In a new autobiography Professor Dawkins told how a master at his Salisbury prep school had pulled him on to his knee and put his hand inside his shorts’, adding that other boys had been molested by the same teacher.

While he said that he had found the episode ‘extremely disagreeable’ he wrote: ‘I don’t think he did any of us any lasting damage.’

Those of us who work in and around child protection have worked with enough parents from that age to know that they live with the haunting memories of the abuse from those times. In my view, Dawkins minimizes the impact but also creates a patina of acceptance for what took place. Consider the following:

• In Mount Cashel orphanage in St. John's, Newfoundland where state wards were routinely physically and sexually abused by the Christian Brother's of Ireland. This occurred through the 1950's;
• How about the literally hundreds of victims of Jimmy Savile in the UK;
• In Canada, there were several churches involved in the residential schools where Aboriginal children were stripped of their identity and dignity through neglect, physical and sexual abuse;

These are but three high profile cases amongst thousands that could be added to the list. But most importantly, Dawkins fails to see that what he is describing is the abuse of power by a teacher who is engaged in grooming a child towards greater sexual involvement. In his case, it may have stopped for any number of reasons. One can almost be certain that the teacher he speaks of has other victims, some of whom would have been less fortunate than Dawkins.

The clinical research tells us that those who use their position of authority to take sexual advantage of a minor, typically have several victims. In order to help reduce this type of sexual abuse, we need to educate children about both protecting themselves and being open about advances that may occur. As a society, we also must respond to those who do offend. Seeing it as Dawkins describes it is dangerous as it dismisses the importance of the offence.

Dawkins says that he got over it - maybe he had a good support network; had resiliency; had a way to compartmentalize the event - but for millions of others, these sorts of events have created life long damage that has impacted their lives in multiple ways.

In essence, he has become the apologist for the abusers. That is the most dangerous aspect of his thinking.

Coincidentally, some rather poignant research was published in Frontiers in Psychaitry:

Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13–17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2–17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs “below the surface” in the vast majority of higher-impact cases. 

This research emphasizes the long term impact of sexual abuse in most cases.

Reference for research

Martin, E.K. & Silverstone, P.h. (2013). How much child sexual abuse is "below the surface" and can we help adults identify it early? Frontiers in Psychiatry. published online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711274/

 

Apparently not all trauma is created equal

I am fascinated by a new study just published by Hickman et al., in the Journal of Interpersonal Violence. As the abstract notes, the research set out to look at how lifetime vioklence exposure is realted to a set of negative symtpoms in children. Those included child internalizing and externalizing behavior, child trauma symptoms and parenting stress. In essence, these are core questions in child protection. A high number of children involved with CPS have been exposed to various forms of trauma. The research had a good sample size meaning that the data was robust. The children were under 5 years of age.

The research spoke about poly-violence as being more dangerous in its long term effects. They defined this as being exposure to multiple violence categories. Intuitively, this makes sense. If there are few, if any, safe environments in your life, it is quite hard to ever settle down. The alarm system of the body is heightened on a continuous basis. Such individuals will tend towards hypersensitivity and hyper alertness.

As the researchers note on p. 1339 of their article. "...exposure to violence has been linked in numerous studies to various developmental and mental health consequences...."

A child who has been exposed to a single form of violence may have resiliency options elsewhere in their lives. In other words, they may have safe havens. One exception seems to be sexual abuse which has a special meaning which was the least common (likely the most damaging) whereas witnessing violence was the most common.

Discussions about broad safety in our society need to consider this type of research. It is perhaps quite relevant given the discussions in the USA about gun violence which can be pervasive in some areas and the high profile issues of rape and the safety of women in India. Perhaps what we have not been focusing on is the creation of true safety for people.

Reference:

Hickman, L.J., Jaycox, L.H., Setodji, C.M., Kofner, A., Schilt, D. & Harris, R. (2013). How much does "How much" matter? Assessing the relationship between children's lifetime exposure to violence and trauma symptoms, behaviour problems and parenting stress. Journal of Interpersonal Violence, 28 (6), 1338-1362. http://dx.doi.org/10.11770886260512468239 

Incest in America

There has been a lot of well deserved attention on the plught of women in India as a result of the high profile rape case that is presently before the coutrs. Research in India identifies that the rate of sexual abuse is bery high - over 50% of children according to the officicial statistics. But a new article in The Atlantic tells us that we in the west should save our smugness, if indeed there is any left after the likes of Cardinal Mahoney in Los Angeles, Gerry Sandusky at Penn State, Graham James in canada and Jimmy Saville in the UK.

However what the article describes is a large, secret problem in the USA (and probbaly in other western countries). It is the dirty secret we do not want to talk about. The article notes:

Here are some statistics that should be familiar to us all, but aren't, either because they're too mind-boggling to be absorbed easily, or because they're not publicized enough. One in three-to-four girls, and one in five-to-seven boys are sexually abused before they turn 18, an overwhelming incidence of which happens within the family. These statistics are well known among industry professionals, who are often quick to add, "and this is a notoriously underreported crime."

The repotr helps to show how significantly under reported sexual abuse is thus causing one to wonder about under repotring. It also notes that the prime place where sexual abuse takes place is within the family systems.

This is a conversation that we need to have but for which child protection and criminal justice systems are woefully unprepared to have at this scale. One can only imagine the impact if more and more victims begin telling what has and is happening. Yet, that is precisely what we need to encourage. The more the secrets leak out and victims can see society respond supportively, the safer it becomes for victims to disclsoe.

The notion of the family as the primary unit of our society makes sense but only when that has a foundation of safety, nurturance and oportunity for growth. Sexual abuse provides just the opposite.



The Atlantic article is worth a read.

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. 

Sandusky - A socially skilled child molester?

The Pittsburgh Tribune-Review published a recent article looking at the apparent ability of now accused child sexual abuser Jerry Sandusky to ingratiate himself into lives of children.  As the paper notes:

Long before his arrest this month on 40 charges related to child sex abuse, Sandusky successfully navigated the system's various background checks to become the adoptive father of five sons and a daughter, a foster parent, a host for a half-dozen Fresh Air Fund children from New York City and a congressional honoree as an "Angel in Adoption."

As the article points, no system is perfect but Sandusky appears to have managed to keep a profile as the helpful and supportive person who was there for many children. His behaviour should cause professionals to revisit the work of Carla van Dam, PhD and her 2006 book The Socially Skilled Child Molester. In it, she speaks of the ways in which people like Sandusky become trusted and, even more important, how they continue to get away with it. She notes that information remains buried in one of three ways:


1. Nothing is ever reported;
2. The information is reported but ignored, discounted, discredited and then discounted; or
3. The information is actively suppressed to protect the organization's reputation and the good name of the alleged offender.


The third will seem all too familiar in cases of church abuse, the recent allegations involving the Boy Scouts in Canada and the United States as well as the allegations surrounding Sandusky.


Van Dam speaks of 6 levels that organizations can fall into. They seem helpful as a way to approach organizations and help them to be better prepared to think about the possibility that an abuser could become part of their world. Individuals, organizations and communities can be at these places: 


1. total secrecy - stuck at the level where there is total denial that this could happen and they are naive to the practices of groomers. These are dangerous places for children as groomers may find entry much easier. Even when there are suggestions that something might be going on, it is easier for the groomer to deny, claim it was all a misunderstanding, there is a conspiracy against them, it was all innocent play, it was just poor judgment, there were medical concerns that were being addressed, it was part of parenting, helping out with hygiene or bathing, it was all just an accident or even that in some way the child was the offender or why would that child be believed because the child has problems.


2. Shock and disbelief that leaves the organization immobilized leaving them willing to accept alternative explanations because they don't want to believe that this could happen.


3. Street knowledge in which there is acceptance that molesters exist but not amongst anyone they would know.


4. Complaints are made and believed but they are seen as isolated and can be managed internally.


5. Allegations are taken to the police because there is recognition that even known and well liked people can be involved in molestation of children.


6. These are vigilant groups who recognize the need to be open and talk about what might be happening.


It is never to say that we want to create panic or extreme paranoia - only honest and open awareness. Since no system is perfect, communication, openness and a willingness to accept the possibility of sexual abuse will help to limit what a perpetrator can accomplish.


Reference:


van Dam, C. (2006). The socially skilled child molseter: Differentiating the guilty from the falsely accused. Binghamton, NY: Haworth Press.


Tonight there is the Bernie Fine case from Syracuse that is reported in the New York Times which tends to illustrate some of these points.