Handbook on Sexual Violence (96 page)

To what extent can such policy alternatives respond to a range of offenders, offence types and victim experiences?

To what extent do they facilitate a refocusing away from ‘the monstrous

stranger-danger’ to the sex offender who is daily in our midst?

To what extent do they enable victims (actual and potential) to respond to sex offending in a meaningful and effective way?

Whilst the chapter does not claim to offer a comparison of criminal justice policies to public health and voluntary alternatives (see McAlinden 2010 for such a comparison), these questions do indicate some possible future criteria upon which such a comparison could be made.

An alternative paradigm: Public health and voluntary responses to sex offending

Alternative responses to the largely retributive sentencing of the criminal justice system have largely been initiated and located within the third sector and public health responses to child sexual offending, most notably within faith-based communities or survivor groups (Kemshall and Wood 2007; Kemshall 2008: chs 4 and 5). In brief, these responses largely reject the punishment paradigm, and characterise sexual offending as a public health issue. Survivor groups in particular have been critical in foregrounding the range of victim experiences of both women and children (Kelly 1998; Tabachnick and Dawson 1999), and the importance of earlier intervention to

prevent repetitive serious harm (
www.stopitnow.org.uk accessed 16 February 16 2010).

The public health approach

The characterisation of sexual and violent offending as a public health problem is most easily attributable to the work of Richard Laws (1996, 2000). In brief, Laws argues that traditional, reactive responses to such offending located predominantly in the criminal justice system have not proved to be effective in reducing the incidence of sexual or violent offending, and that perversely such approaches inflate public fears and rejection, particularly of sex offenders (2000: 30). The public health approach is characterised as preventive and ‘forward-looking’. The ‘public health approach’ (PHA) has gained ground as a novel and potentially more effective method of dealing with child sexual abuse, and to a lesser extent adult sexual abuse and violent offending.

The PHA is located at three levels: the primary, secondary and tertiary:

the primary level
: at which the goal is prevention of sexually deviant behaviour before it starts, for example the identification and prevention of sexually deviant behaviour in children, and the long-term prevention of adults engaging in sexual abuse;

the secondary level
: at which the goal is the prevention of first-time offenders from progressing, or the opportunistic and ‘specific offence’ offender from becoming a generalist;

the tertiary level
: at which the goal is effective work with persistent and more serious offenders. Specific goals are usually effective treatment programmes and relapse prevention.

(see Laws 2000: 31)

Laws argues that as an alternative to (largely ineffective) incarceration, increased efforts should be targeted at levels 1 and 2. This requires increased attention to ‘prevention goals’ of which the following are seen as the most important:

Public awareness and responsibility
: This involves informing the public of ‘the magnitude and characteristics of sexual offending’, including how sex offenders groom, but more importantly that sex offenders are part of the community. The emphasis is upon adult responsibility for responding to sex offending, particularly against children.

Public education
: This involves challenging the myth that all sex offenders are demons and incapable of change, and an emphasis upon treatment programmes that work. The message that something can be done and that treatment is worth investing in is a key one.

These prevention goals are supported by direct targeting of sex offenders, to encourage both active and potential sex offenders/abusers to come forward for treatment. The emphasis is upon the prevention of those beginning to engage in abuse or thinking about it, and relapse prevention for those with established behaviours. Harm reduction and risk minimisation are seen as key

components of such a strategy. As such, public health approaches offer a reasonable fit with Kelly’s continuum model in so far as they target a range of victim experiences, seek to address a range of sexual offences, and enable victims and potential victims to respond to sexual offending in a positive way, for example by providing information to spot and address grooming behaviours (Kemshall 2008; the Derwent Initiative (TDI) 2007).

However, there are important limits to PHA. Within the UK for example, a key strand has been public awareness and education campaigns, pursued primarily by ‘Stop It Now!’, and the Lucy Faithfull Foundation (for a full review see Kemshall 2008: 78). Within the UK and Ireland, Stop It Now! has pursued three aspects of work:

public awareness, public education and media campaigning;

treatment and counselling for sexual offenders;

a helpline targeted at adult abusers and those at risk of abusing; family and friends of abusers; parents of young people who are engaging in sexually inappropriate behaviours.

(www.stopitnow.org.uk accessed 16 February 2010)

However, in all three areas of work there are difficulties in the practical delivery of work, and in operating along the continuum identified by Kelly. In addition, PHA responses have largely focused on child sexual abuse, with some limited concern with sexual offending against adults. The next
section will review these difficulties in some detail.

Limits and difficulties with PHA responses to sexual offending

Stop It Now! (and similar organisations) attempts to build public awareness and community responsibility for sex offenders by influencing public debate and government policy on sex offenders, for example through lobbying, media campaigns, and direct communication with local communities. The latter has been the subject of a more recent initiative under the Home Office Child Sex Offender Review (CSOR) and involved a pilot of a public awareness campaign by the Lucy Faithfull Foundation with the conclusion that such campaigns have to be intensive, long-term and part of a broader awareness strategy (Collins 2009). However, there was some resistance to the message and the pilot events were not well attended, illustrating that the public find this a taboo and ‘emotionally aversive’ topic for discussion (Sanderson 2005). In the Lucy Faithfull pilots ‘hard-to-reach’ groups and ethnic minorities also proved challenging to engage.

In their earlier evaluation of Stop It Now! dissemination and public awareness campaigns Kemshall
et al
. argued for a strategy of working:

through targeted partnerships where the partner agency can carry the message into key user and key audience groups. This avoids ‘wasting’ the message, enables strong follow up and evaluation within more tightly bounded groups and enables a clearer cost-benefit analysis to be applied to dissemination.

(Kemshall
et al
. 2004: 12)

In addition, the authors concluded that communication needs to be:

considered as a strategic issue within which cost-benefit is considered rather than viewing communication as a matter of pragmatism or opportunism.

(Kemshall
et al
. 2004: 13)

However, public health campaigns are fraught with difficulty (Alaszewski 2006), not least that messages are prone to distortion by the media and can result in panics rather than rational discussions or debate (see Barnett and Breakwell 2003 on BSE; Boseley 2002 on the MMR vaccine debate). This has been particularly acute in child sexual abuse (Kitzinger 2004), an ‘emotionally aversive’ topic exacerbated by cultural taboos (Sanderson 2005). A key flaw of such public awareness campaigns is to underestimate the range and weight of intervening factors between the message and the receiver of the message. Social actors are not mere ‘media dupes’, but actively interpret, filter, select and rationalise such messages militating against a simple ‘hypodermic’ model of information giving and receiving (Kitzinger 2004; Hughes
et al
. 2006). Based on a range of health prevention studies, the Health Belief Model (Glanz
et al
. 2002: 52; see also Rosenstock
et al
. 1994) outlines the ‘modifying factors’ that can inhibit individual perceptions turning into actions. For example, the cognitive schema against which information is perceived and processed; whether the message can alter the cost–benefit analysis that individuals have; whether an individual believes they are ‘at risk’; the costs to the individual of modifying (or not) their behaviour; and the individual’s ability and self- efficacy to take actions (see for example Alder 1997 on sexual behaviour; Denscombe 2001 on smoking; Miller and Kitzinger 1998 on AIDS; Eisen and Zellman 1986 on medication compliance; Thirlaway and Hegg 2005 on alcohol and cancer). Public awareness campaigns on sexual violence show similar results, with campaigns on dating violence prevention showing low impact (Cornelius
et al
. 2009), with the cognitive schema of potential victims (that they do not think they are likely to be targeted or to be ‘at risk’) impacting on their reception and processing of key advice. Research shows that the prevalence and acceptability of ‘rape myths’, for example that victims are to blame, can result not only in some victims not reporting rape or to potential victims having an illusory perception of safety, but also in offenders and potential offenders rationalising sexual violence (see Bohner
et al
. 2009 for a full discussion). In addition, the power of such cognitive schema, particularly when institutionalised into criminal justice practices, can result in less impact for public and professionally targeted awareness campaigns about the nature of rape.

This wide-ranging body of research literature on public awareness/ information campaigns suggests that to be successful you have to:

maximise the relevance of the message to the audience (Foubert and McEwen 1998);

maximise audience perception of susceptibility to the risk (Bohner
et al
.

2009);

give a clear message re benefits (Boseley 2002);

promote self-efficacy and key actions that can be taken by the individual (TDI 2007; Kemshall 2008).

Building responsibility and engagement is also problematic. Communities and publics may resent ‘being made responsible’ for risks which they consider are the responsibility of paid professionals (e.g. police and probation); and involuntary risks are particularly resented (Slovic 2000). Increasing the awareness of professionals and parents about child sexual abuse is laudable although the extent to which it is reducing child sexual abuse is more difficult to discern (Kemshall
et al
. 2004). PHA displaces responsibility for risk management onto communities, treating them as a potential source of vigilance, monitoring, support and control – the community is seen as a resource for risk management (Kemshall and Wood 2007, 2008). However, risks and the resources to manage them are inequitably distributed (Johnston 2000) and some communities literally struggle to manage the risks within their midst. As Kitzinger puts it, ‘some communities already felt under siege’, particularly on under-resourced and under-policed housing estates (2004: 151). These perceptions were heightened by housing inequalities, poor local services and the release of prisoners into strained communities, coupled with perceptions that professionals could not provide sufficient protection. In this climate the public may conclude that it is having risks foisted upon it, with a differential impact upon various communities, and that ‘involvement’ is an official term for ‘dumping’.

As early as 2001, the ‘Report on the Expert Panel on Sex Offending in Scotland’ (also known as the Cosgrove Report), argued for the involvement of the public in determining the development of effective community management strategies for sex offenders. Cosgrove expressed it thus:

The final strand in this approach to community safety is the need to empower and involve local people in making their communities safer places to live. In the past, action by communities has not always been constructive or safe. It is therefore important that the management of sex offenders commands public confidence and that communities are encouraged to become involved in a constructive fashion.

(p. 12)

However, engaging communities in a ‘constructive fashion’ has not always found policy support in the UK, particularly in England. The Home Office Child Sex Offender Review (CSOR) (Home Office 2007) attempted to broaden policy responses to sex offenders. The review focused on current practice with sex offenders, including work abroad, and its recommendations aimed to:

provide greater child protection. This may be achieved through reducing re-offending by known offenders, preventing initial offending, and identifying where offences are taking place by increasing people’s confidence to report them.

(Home Office 2007: 5)

In essence, the report attempted to straddle two strands of thinking in the effective management of sex offenders – a strengthening of statutory responses and increased restrictive conditions; and a public awareness/education response rooted in the public health approach. The latter reflected the considerable influence of the children’s charities such as Barnado’s, NSPCC, and Stop It Now! Their influence is represented in the following comment within the Home Office report:

During the review, those involved in protecting children stressed the importance of public involvement in enhancing child protection. We need to give the public the means to fulfil this role, and we need to achieve a culture change whereby the relationship between the police and the public is more open, with information being shared in both directions.

(Home Office 2007: 9)

The review acknowledged that targeted public awareness and education of parents, particularly around grooming behaviours, and helping the public to accept and recognise that most sexual offenders are known to the victims, were important but difficult messages to achieve. In essence, this view attempted to counter the media presentation of all sexual offenders as ‘predatory monsters’ and to some extent better reflected Kelly’s continuum of sexual offending.

To this end, action 1 of the review recommended a public awareness programme in partnership with ‘non-governmental organisations’, and in 2008–09 a pilot involving the Lucy Faithfull Foundation/Stop It Now! was carried out (as discussed in brief above). To support this, and to enhance public confidence in the police and greater dialogue between the two, action 2 of CSOR proposed ‘increased awareness of how sex offenders are managed in the community’ (p. 28). The report proposed easily accessible public information, especially about the statutory multi-agency public protection arrangements (MAPPA). The latter was not to involve public disclosure about individual cases (although MAPPA do have the power to disclose to third parties where risk and case management justify it), but was intended to ‘reassure the public that protection arrangements are in place, and to ensure a transparent system operates in which the public is fully aware of the true level of risk’ (Home Office 2007: 9). The MAPPA guidance 2009, however, gave little emphasis to communication with the public, providing six lines of coverage in section 25.7 (p. 220) stating:

Two challenges facing MAPPA are how to effectively manage public expectations and how to handle media interest. The national MAPPA Communication Strategy requires each RA to produce and implement a media strategy and an annual communication plan. SMBs should make good use of the MAPPA leaflet, ‘Keeping Our Communities Safe’, to promote the work of MAPPA in its local area.

(Ministry of Justice 2009: 220; and Home Office 2008 for the leaflet)

Whilst the guidance urged Strategic Management Boards to develop a ‘wider strategy of communication and education of the public’ (p. 220), to date this has been largely carried out by annual reports, with limited public accessibility, and with little accountability or transparency to victims or their relatives (as reviewed by BBC Radio Four,
File on Four
, 7 July 2009). The MAPPA leaflet comprises two pages providing a brief overview of MAPPA key functions, and it is difficult to see how this could be considered as a core feature of a public awareness and education strategy with local communities. There is no consideration of hard-to-reach groups, communication strategies to encompass diversity, or how to convey difficult messages about risk to the public. In this sense, official government policy has remained ‘at odds’ with public health approaches, and to some extent adapts such responses to a predominant community protection paradigm (see Kemshall 2008 for a full discussion).

The public awareness campaign by the Lucy Faithfull Foundation ‘
Educate 2 Protect
’ experienced low take-up from ethnic minorities and ‘socially disadvantaged’ groups despite targeting areas of social deprivation and targeting ethnic populations through relevant print, radio and TV media (Collins 2009). In addition, translation issues especially of key terms, coupled with resistance to a taboo subject and the discussion of ‘overtly sexual’ subjects made engagement difficult (for example one inner city area had 106 different languages and dialects), and female participants were unwilling to discuss sexual matters with a male facilitator. Previous research by the NSPCC (2007) found resistance to reporting child sexual abuse in Asian communities, with a fear that such reporting brought shame onto the family concerned (research supported by Gilligan and Akhtar 2005). This translated into resistance to the Lucy Faithfull public awareness campaign (Collins 2009). The Lucy Faithfull evaluation concluded that recruitment and credibility of staff is critical, as well as the format and content of material.

Treatment and counselling for sex offenders

Treatment should also capture the range of sexual offending outlined by Kelly’s continuum. To some extent, this also presumes early, treatment-based responses rather than an over-reliance on punitive and restrictive measures. However, a lack of treatment programmes for sex offenders who actively request treatment has been seen as problematic (for example sex offenders can refer themselves via the Stop It Now! helpline but cannot always be matched to treatment, see Kemshall
et al
. 2004). A particular difficulty has been the provision of residential treatment units, dogged by adverse community reaction and opposition, and the lack of community based treatment programmes offering intensive structured programmes and relapse prevention. The latter are almost exclusively offered by probation or prisons under a ‘punishment paradigm’ in response to offending, and very little is offered as a preventative measure. In effect, these probation or prison-based treatment programmes are largely located at the tertiary level of intervention and targeted at either serious of persistent offenders, making Kelly’s continuum largely redundant in practical terms. Such programmes are also characterised by a cognitive behavioural approach, focusing on changing ‘distorted thinking’

and remoralising the risky subject (Kemshall 2002). Whilst there is considerable evidence of effectiveness (Brown 2005), cognitive behavioural therapy has been criticised for its simplistic approach to sexual offending (Laws and Marshall 2003); lack of attention to the power dynamic in the commission of offences (Worrall 1997); and the over-emphasis upon confrontational techniques (Sheath 1990; Vivian-Byrne 2004). CBT has been refined in more recent years with greater attention to social factors, pro-social modelling and the role of the therapist, and treatment integrity (Dowden and Andrews 2004; Mann 2004; Marshall
et al
. 2003). However, CBT is still largely characterised by control and a correctional agenda (Kemshall 2002). More recent research evidence and policy developments have attempted to develop more integrative approaches (see Kemshall 2008 for a full review), for example through the use of resettlement and accommodation strategies to ensure stability and continuity of monitoring and interventions for offenders (NPS 2004: 6; Chartered Institute of Housing Scotland 2005). Increased attention to ‘needs’ has also been promulgated, with a recognition that where legitimate, the satisfaction of needs can increase not only motivation and compliance, but also the effectiveness of parallel interventions (see discussion on the ‘Good Lives Model’ below).

A key element in the Stop It Now! prevention and treatment of sexual offending is the helpline. The helpline has national coverage and seeks to provide information and advice for adults who are concerned about their own behaviour or the behaviour of someone they know. The targeted population for the helpline is: