Communication and collaboration in sexual abuse working

Over the last couple of months, we have participated in conferences, meetings and collaborations in our home regions of the UK and US as well as abroad (Netherlands, Latvia, Australia, Canada, Germany, Romania, Namibia); a central theme in each location has been that collaboration is the key to working in the field of sexual abuse. We have been amazed by how this most simple aspect of our work is often the most challenging; one would think that something as simple as collaboration would be easy to achieve, but this is not always the case!

Despite our field’s progress with assessment and treatment technology, we are all still human beings for whom miscommunication can come quite naturally. Collaboration may be the most important tool we have, and perhaps the least expensive, and yet it is highly dependent on the capacities and interpersonal skills of those who engage in it. Sometimes, we forget to simply pick up the phone and contact people.

Collaboration is vital: we work in consistently changing environments with practical challenges and related issues. For instance, in the multi-disciplinary/multi-agency UK, some current issues are:

–          The introduction of new sex offender treatment programmes in the UK known as the Kaizen  (a replacement treatment program for high or very high risk sex offenders) and Horizon (a replacement treatment program for medium risk sex offenders) roll out.

–          Upcoming Brexit negotiations and the impact upon movement, sentencing and punishment of sexual offenders – especially monitoring and data sharing.

–          An ongoing conversation about how to respond to increasing numbers of online offenders entering the Criminal Justice System.

–          Evolving sex education and sexual abuse safeguarding in schools.

–          Changes to the funding of state services, like probation, and the impact that this has on the management of offenders.

However, these are not only UK issues. Other countries have these issues and more, including:

–          Differences within the same country on viability of using the same sex offender risk assessment scales (USA and elsewhere)

–          Getting different organisations, especially within the public health system, to work effectively together (Latvia and many Eastern European Countries)

–          Getting criminal justice systems interested in providing treatment to people who have abused in the first place when moral and religious beliefs can interfere with developing an empirically sound understanding of these individuals (Eastern Europe and elsewhere).

–          Ensuring that agencies that can disseminate information that can aid in the prevention of sexual abuse and sexually transmitted infections actually reach their target audiences (Namibia and elsewhere).

All of these situations reflect a lack of professional collaboration. Often, they reflect the disagreements in the processes and practices of sexual offended management which can lead to poor practice and bad policy. Sometimes they reflect the strong beliefs – even egos – of those involved. We often say that we collaborate with others, but our practices, organisations, and/or tasks can get in the way of this. We are sure that we are not alone in having attended meetings that trumpet good collaborative working, but nothing gets carried forward as no-one is really listening.  This is frustrating (and a possible compromise of public health and safety) because a lot of these issues are well within our sphere of influence to change through better, more honest, and more open communication, as well as collaboration. By working together in a more constructive, multi-faceted, multidisciplinary we can reduce sex offending, improve risk management, improve public protection and improve the prevention of sexual abuse in the first instance… but it begins with us. So how should we do this?

–          Communication with other professionals, the public, policymakers and the media. Always leave the door open and be willing to have the conversation from a place of wanting to learn, not a place of seeking confirmation of your practices.

–          Actively check in with others and cultivate an openness to feedback.

–          Always share good practice with others, do not be covetous of your only good practice. If something works, share.

–          Debate bad/poor practice within your own work and in the projects that you are working within; don’t be afraid to say that something is not working and needs to change. If there is anything we have learned from recent worldwide elections it’s that we are not as effective at changing our minds in the face of evidence as we think.

–          Collaborate with other related individuals within the field; this will lead to a multi-disciplinary approach that will improve the situation of everyone.

–          Never, ever forget the importance of developing and maintaining professional relationships. As they say in David’s agency, a little love can go a long way.

Kieran McCartan, PhD, and David Prescott, LISCW.

Considering the alternatives to traditional Child Sexual Abuser risk management: Prevention?

Risk management often involves a difficult balancing act between public protection, victim empathy, victim support as well as offender punishment, deterrence and rehabilitation; quite often one is achieved at the cost of others. This balancing act becomes compounded if you are dealing with a high profile offender population, like child sexual abusers and/or paedophiles, because you are dealing with many interested parties outside of the state-run criminal justice system who understandably want their voice heard and their opinions counted; which is appropriate and correct, however you factor into financial austerity, cuts in frontline services, an increase in reporting /recording crime, more people being sent to prison, more people being managed in the community and an increase in penal populism you can end up with the “perfect storm” of a crisis in risk management. Currently, in the UK, and in other western countries including Australia and USA, we are seeing this in regard to child sexual abuse with increasing offenders numbers of victims and offenders being identified and entering the system. The increase in reporting rates and therefore the identification of perpetrators, victims and the resulting finical impact of child sexual abuse is as a result of a number of distinct, but integrated factors, including;

(Please see these articles for a further discussion – O’Sullivan, Hoggett, McCartan & Kemshall, 2016; McCartan, 2014; NSPCC, 2016; Journal of Sexual Aggression Special edition 1)

Consequentially, how do we weather this storm? It is becoming more and more obvious that a change in tactics is needed; a balancing act of more effective/increased prosecutions, with more victim support, better risk management approaches and preventive strategies. Yesterday Chief Constable Simon Bailey, of the National Police Chiefs’ Council, stated that the police cannot cope with the current influx of child sexual abuse investigations and that we have to look differently at how low-risk offenders are managed (BBC NEWS). While this may seem like a controversial statement on the outside it is not the first time that the police have said this regarding online sexual abuse and child sexual abuse imagery (Jon Carr; NSPCC; National Crime Agency; Journal of Sexual Aggression Special edition 2). It is important to state that not all types of Child sexual Abusers are the same, not all pedophiles abuse and not all abusers are pedophiles; they are a diverse and individualistic group. We know that not all individuals who sexually abuse children, either through viewing imagery or a contact offence, are share same level of risk and that not all levels of risk get the same punitive and/or rehabilitative response from the state. In terms of low-risk offenders, who Simon Bailey was discussing, they will not receive a sex offender treatment programme or receive a full risk management plan or MAPPA (Multi-Agency Public Protection Arrangement) in the community. We are dealing with them differently in all other aspects so his argument is an extension of this. Additionally, in rethinking how we tackle low risk, and possibly medium risk, offenders it means that we can look to prevention as a viable means of intervention; can we identify these individuals earlier, through other means (i.e., through redirection from online sites [Stop it now], predictive analytics [current piece of research being carried out  with Avon and Somerset police, Bristol City Council and the University of Western England] or encouraging people who are concerned about their behavior to come forward and seek support [Safer Living Foundation; Circles South West]). Interestingly today the English government has decided to re-examine sex education and healthy relationships in primary and secondary schools (BBC 01/03/2017), which is a departure from their previous position (BBC 11/02/2016)

It seems obvious that an alternative to our past practice is needed (and even police officers are now saying this publicly), we need to recognizing that rethinking sex offender risk management is an not an act of acceptance of offending, offenders or their lifestyles as appropriate, but rather its recognition of practicality, resource management and effective engagement. The ultimate question is whether we want them to do it again or not? And assuming the answer is no, what effective action can we take?

Effective risk management must comprise deterrence, sufficient and effective treatment for victims/survivors and offenders and crucially primary prevention activity including sex and relationships education in all schools, advice and information for parents, professionals and communities as a whole to ensure full engagement and a promotion of the understanding that we all have a role to play in child and public protection.

Kieran McCartan, Ph.D, Jon Brown, MSc, & David Prescott, LISCW.

The prevention agenda in 2017….

In 2016 we started to see a growing recognition of sexual harm as a public health issue, in particular the preventative nature of child sexual abuse. In general, preventing child sexual abuse has often happened at the primary [broad societal education and messages] and tertiary levels [sex offender treatment, the good lives model, risk management and public protection]; but this is starting to change. We have heard about Project Prevention Dunklefeld, in Germany, but there has been nothing to date in the UK; this, however, is starting to change. In 2015 and 2016 we saw the roll out of Lucy Faithful foundations engage program aimed at “aim risk” viewers of child sexual abuse imagery; the Help wanted! Programme in the USA.  Also, the Safer Living Foundation and Circles South West in England are now looking at an English speaking version of Dunkelfeld; the NSPCC plans to develop Together for Childhood centres which will trial and evaluate a place based approach to preventing sexual abuse; and colleagues in the Netherlands are starting to work with “non offending paedophiles”.  While this encouraging  and mportant work there is still more to do to embed the prevention of child sexual abuse in our national thinking and practice, including:

  • Education with all parts of society about what child sexual abuse is and how potential perpetrators can behave. Then we can start to discuss what the prevention of child sexual abuse is, how it can work and why it is important. This needs to happen at all levels, but perhaps the place to start is in schools, GP surgeries and other primary health care in the heart of our communities.


  • Research and development into whether prevention and secondary prevention with at risk offending populations works, because at the moment we don’t know if it does. A lot of the research is in its early stages and relatively immature. We need to develop a robust evidence base, but that takes time, investment and pilot studies.


  • Policy makers, government and organisations need to be convinced that prevention of child sexual abuse is possible and how it would be done in a practical as well as an achievable way. Pevention will never be endorsed without a developing evidence base. However, we have started to see prevention in other areas of social welfare in England and Wales recently with the Troubled Families initiative, the Better Stat programme and programmes working with perpetrators of domestic violence.


  • Partnership working is central to preventing child sexual abuse; we do it post offending, post-conviction and during release so why not beforehand. We can link social workers, councils, police, businesses and charities/NGO together more effectively so that they can work together to detect, predict and respond to potential child sexual abuse situations before they occur.
  • Media engagement is important to changing the social and political construction of child sexual abuse and how we respond to it. The media informs debate and shapes policy, practice and public opinion. Having a media dialogue, followed by a media buy in will help with the development and roll out of any prevention agenda or practice.


The field of child sexual abuse prevention has taken significant steps in 2016, but there is still a way to go to catch up with and learn from other areas of violence reduction, children’s health and social care.

Working collaboratively, making the case to government and focusing on these areas we can make further significant progress in the prevention of sexual abuse and violence this year.


Kieran McCartan, Ph.D, & Jon Brown, MSc

Public Engagement and Changing Attitudes about Sexual Abuse

This is a reprint of a blog on public engagement and sexual abuse prevention from the SAJRT blog. After reading this if you want to know more about public engagement and sexual abuse prevention in the UK please join us at the NOTA Public engagement event on Wednesday 28th September 2016 at the Hilton Metropole Brighton from 6.00 – 7.30pm. Kieran

Sexual abuse is a complex and emotional public health issue that impacts everyone – individuals, communities, institutions, and society as a whole. Despite this reality, sexual abuse remains a difficult topic for open discussion and the complexities of sexual abuse are often not reflected by public opinion. This is understandable when we recognize that our perceptions are often influenced by the way sexual abuse, sexual abusers, and survivors are portrayed in films, on television, and in the popular media – too often a one dimensional and sensationalized, rather than factual, presentation. If our goal is to prevent sexual abuse and ensure there are no more victims, it is essential that the public become engaged and educated about sexual abuse, those who perpetrate sexual abuse, and strategies to prevent sexual abuse.

Studies have shown that reported offending has decreased for all types of crimes over the past 20 years and this is also true for sexual offending, both in the United States (Finklehor, 2004; Lauritsen & Rezey, 2013) and the United Kingdom (Crime statistics for England and Wales, 2013/14). Research on sexual abuse within the criminal justice and psychology fields has also vastly progressed over the past 30 years (Wilson & Prescott, 2014; Marshall, 2011) and we now know more about those who perpetrate sexual abuse,  their motivations, etiology and rehabilitation than ever before (ATSA, 2014; Wilson & Prescott, 2014; Carter, 2014). We also have more clearly defined laws and evidence-based criminal justice approaches for the management of individuals convicted of sexual crimes than ever before (CSOM, 2008; Kemshall & McCartan, 2014), as well as a greater understanding of innovative reintegration strategies that promote public safety, including community-based strategies such as Circles of Support& amp; Accountability. We are even starting to see the traditional media reporting on sexual abuse in a more balanced, realistic, and engaged manner.

Despite these positive changes towards greater community engagement and understanding, improved victim services, and more effective treatment models, the most common attitude of the general public continues to be that nothing works for “sex offenders.” (McCartan, 2004, 2010, 2013; McCartan, Kemshall & Hudson, 2012). This is the greater paradox within our field, as well as criminology/criminal justice in general – public perceptions do not coincide or reflect professional experiences, or what the research tells us about the reality of the situation.

This divergence between public attitudes and understanding versus the realities of sexual abuse is fuelled in part by myths created through stereotyping, miscommunication, prejudice, active disengagement, and poor professional interaction – all factors which speak to the need for greater public engagement and understanding about sexual abuse in order to facilitate prevention and safer communities. Public engagement is important for a number of reasons, including;

  • Community and self-protection: By better understanding the aetiology, behaviours, offence patterns, criminal justice responses and treatment models related to sexually abusive behavior, individuals are better prepared to protect themselves and others. Therefore education and understanding is a self-defense mechanism, as well as an integral component to creating a culture of non-acceptance of sexual abuse which promotes prevention (e.g., bystander intervention programmes).
  • Supporting appropriate responses to sexual abuse: The appropriate response to sexual abuse, like any crime or case of neglect, is to report it to the appropriate authorities so that they can respond to it. It is not to take the law into your own hands (McCartan, 2010; Vigilante hunter case, Daily mail, Independent; Haas, 2010) or too ignore the issue. By better understanding what the reality of sexual abuse is, what the authorities do (and why they do it in that way), and how sexual offense specific treatment and management works,  the public is better equipped to make informed decisions, as opposed to uninformed ones.
  • Dispelling miscommunications and rectifying myths: Sexual abuse has a lot of associated myths, whether these are rape myths, victim blaming, myths about who commits child sexual abuse, or the impact of abuse depending on the gender/age/ethnicity/cognitive ability of the offender or victim. These myths help no one and actually often compromise, rather than promote, public safety. By greater engagement with individuals and communities, through better education programmes and through more realistic media engagement, we can dispel these myths. While this may be a difficult task due to many of these myths being hardwired into our personal and cultural psyche, by dispelling these myths we can facilitate recognition of sexual abuse for the complex public health issue that it is and move forward towards a culture of prevention.
  • Influencing public policy and agenda setting: Public opinion shapes governmental policy and practice, from emotionally driven knee jerk responses to in-depth social change. This means that public opinion is vital beyond a social dialogue as it feeds into legislative and political agenda setting. A more engaged public results in a greater understanding of the reality of sexual abuse and the complexities of responding to these issues and this, in turn, leads us to a more informed and realistic sociological debate. It also results in the public campaigning for evidence based policies and laws that are both preventative and responsive, public health oriented as well as criminal justice oriented, and forward thinking rather than reactionary.

While the prevention of sexual abuse may feel like a never ending task, we have come far over the past 30 years in not only our understanding of sexual abuse, but in our support of survivors, management of perpetrators, and prevention efforts. But our work is far from done and public engagement is key to continuing forward – although the prevention of sexual abuse requires a well-planned and comprehensive response founded on research, it is only through education, collaboration, and the involvement of everyone – community members, violence prevention professionals, victim advocates, law enforcement professionals, treatment professionals, journalists, and policy makers – that the prevention of sexual abuse can become a reality.

Kieran McCartan, PhD & Katie Gotch, MA


Association for the Treatment of Sexual Abuses (ATSA) (2014). Eight things everyone should know about sexual abuse and sexual offending. Beaverton, OR: Author.

Carter, A. (2014). Sex Offending Treatment Programmes: The importance of Evidence based practice. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 111 – 126. ISBN 9781137358127

Center for Sex Offender Management (CSOM) (2008). The comprehensive approach to sex offender management. Silver Spring, MD: Author.

Finkelhor, D. & Jones, L.M. (2004). Explanations for the decline in child sexual abuse cases. Juvenile Justice Bulletin, January 2004. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Haas, N.E. (2010). Public support for vigilantism. Leiden: Universiteit Leiden.

Kemshall, H. and McCartan, K. (2014) Managing sex offenders in the UK: Challenges for policy and practice. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 206-226. ISBN 9781137358127

Lauritsen, J.L. & Rezey, M.L. (2013). Measuring the prevalence of crime with the National Crime Victimization Survey. US Department of Justice, Bureau of Justice Statistics.

Marshall, W. (2011). Milestones in Sexual Offender Research and Treatment. Keynote at ATSA Annual conference. Toronto, Canada.

McCartan, K. (2004) Here there be monsters: The public’s perception of paedophiles with particular reference to Belfast and Leicester. Medicine, Science & the Law,  44. pp. 327-342. ISSN 0025-8024

McCartan, K. (2010) Student/trainee-professional implicit theories of paedophilia. Psychology, Crime & Law, 16 (4). pp. 265-288. ISSN 1068-316X

McCartan, K. (2013) From a lack of engagement and mistrust to partnership? Public attitudes to the disclosure of sex offender information. International Journal of Police Science and Management, 13 (3). pp. 219-236.

McCartan, K., Kemshall, H. and Hudson, K. (2012) Public understandings of sexual abuse and sexual abusers. ATSA Forum, xxiv (3) McCartan, K. (2014) Euthanasia & sexual abusers. Journal of Sexual Abuse blog, 2014 (Sept).

Wilson, R., and Prescott, D. (2014). Community based management of sex offender risk: options and opportunities. In: McCartan, K., ed. (2014) Responding to Sexual Offending: Perceptions, Risk Management and Public Protection. Palgrave Macmillan, pp. 20 – 47. ISBN 978113735812

Understanding how to support the families of perpetrators of sexual harm better in the aftermath of abuse and their role in prevention

Often times we forget about a silent but impacted group of individuals related to sexual abuse, the families of the perpetrators. I spent some time on Friday talking about this with prison staff in the context of the men in their establishment and the regularity as well as reality of visitation time; but I think that it engagement between perpetrators and their families goes much further than this one issue as it impacts their rehabilitation as well as reintegration through having a support structure on the outside. We as researchers, professionals and treatment providers spend our time discussing perpetrators, victims and the criminal justice system but we can give little (or sometimes no thought) to the family members sitting on the side-lines impacted by the abuse and how it affects their lives. It is important to recognise that not all family members want to maintain contact with perpetrators, but some do and others change their mind over the course of time and reopen potentially sealed doors. However, do we really support, aid and help the families of perpetrators? The reality of the situation is, compared to other offending populations and risky populations, probably not, no. The families of perpetrators face a range of ongoing issues and live out the experiences of perpetrators simultaneously, because:

–         Dealing with the label of having a family member who is in prison, or in the community, as a “Sex offender”. Whether this be children of the perpetrator, the wire/partner of the perpetrator having to live in the community [or the house] where the abuse happened. While not everywhere has public disclosure of sex offender information the court case is often printed in local papers and the local “gossip” machine will spread knowledge. However, no one tells family members how to respond, cope and manage with this, epically if it is coupled with the idea that they were aware of the abuse and kept quiet or that they “might be sex offenders too”?

–        Tying in with the label of sexual abuse familiarise are also stigmatised by association, epically if they decide to stick by the perpetrator and work with them. Walking away in some instances garners social support and acceptability; but staying suggests that families are sympathetic and supportive. The stigma that families can face does not recognise the complexity of relationships or abuse, it reiterates a simplistic societal judgement that does not exist for other risky groups (addicts, alcoholics, etc).

–        Quite often families, like victims, blame themselves for what the perpetrator has done regardless of whether the sexual harm was in the home, community or completely unknown. Families will carry this guilt, self-blaming and annoyance (at themselves and the perpetrator) with them while the perpetrator is in prison and post release.

–        They often receive little or no support, financial or emotional, while their family member is imprison. Quiet often these families have lost a means of finical support, either because the main breadwinner has lost their job but also maybe the remaining family member has to give up work [or reduce their hours] to care for the family in the perpetrators absence.

–        Family members are dealing with their own trauma in respect to the perpetrators sexual abuse, in that someone they thought they knew well had done this. How do they process this trauma, where do they go for help and how do they vocalise. In addition, there may be other forms of abuse, trauma and dysfunction that they may have been exposed to at the same time that the sexual harm was happening elsewhere. Who can they turn to for help, support, counselling and/or advice? Some areas have resources and support but this is by no means universal or free.

–        Given the secretive nature of sexual harm and the impact that it has, this means that families carry an additional burden of not being able to discuss the abuse or its consequences; which places them under more internal and external pressure.

–        Visitation, as already mentioned, becomes an issue as the perpetrator may be sent to a prison too hard to access and/or that because you cannot bring children, or minors, with you to a sex offender establishment means that families may not be able to visit (if they wanted to). This means that often time families are divided via practicality rather than choice. Which means that perpetrators and their families are artificially, but meaningfully, separated in a way that does not happen for other types of offenders.

–        The fact that the perpetrator, whether they want them to be or not, is omnipresent in their lives; by default, by actions and by association.  The family may want to help and support the perpetrator, but they may not. If they don’t want to support the perpetrator they may share the same surname, circle of friends and may have to see/hear/discuss them through conversations that they have with family members that still contact them (parents, siblings or children).

The families of perpetrators of sexual harm are placed in a difficult and often invisible situation. We as the providers of research, treatment and support for victims and perpetrators need to think about how we can best assist and support all of those impacted by sexual harm. In addition, the families of perpetrators of sexual abuse can hold the key, in part, to understanding how sexual abuse occurs. Generally, we do not prevent sexual harm, we respond to it; but talking with the families of perpetrators of sexual harm they may help us understand some of the key warning signs better, help us better understand grooming techniques, help us better understand the methods that perpetrators use to hid their abuse, help us identify key moments or perpetrators behavioural shifts better. The families of perpetrators of sexual harm may have been present at the time of the abuse if it was perpetrated in the family , exposed to a range of related issues and often have an insight in to the perpetrators day to day actions better than most. Helping families to reflect upon what was occurring at the time of sexual harm allows us to more clearly understand triggers and warning sign which we can translate into prevention strategies that could be useful to others in similar situations. It’s true that the families of perpetrators need help to manage with what has happened around them but it is equally important that we as researchers, professionals and treatment providers can learn from their experience so that we can prevent future sexual harm.

Kieran McCartan, Ph.D

Understanding the role of Prevention in Child Sexual Abuse

Welcome to this first blog hosted by the NOTA Prevention Committee. The aim of this and future blogs is to stimulate discussion and debate, to inform and to facilitate networking.

 Over the last few decades we have seen an increase in reporting, recording and prosecution of Child Sexual Abuse in the UK & Ireland, as well as internationally (UNICEF, 2014; World Health Organization, 2014). This increase in cases does not necessarily mean that Child Sexual Abuse is on the increase, this is difficult to determine given its hidden nature and baseline recording problems, cases are coming to the fore more often and we are starting to see a more realising picture of the overall prevalence of sexual abuse but it is difficult to know if we are experiencing a real terms increase in sexual violence. Add to this increased reporting the diversified nature of the offences that are recorded included more online offending, more cross border offending, peer on peer abuse and historical reporting; all of which means that the already complex and multi-faceted nature of child sexual abuse is getting more complicated. Therefore it is timely to raise the question of how we respond, rather than simply react, to child sexual abuse? Traditionally in the UK & Ireland, as well as other countries we have adopted a criminal justice approach whereby someone reports being a victim of child sexual abuse or a third party signals a concern and then the system reacts and the identified, suspected perpetrator gets investigated. The issue with this approach is that it is reactive, after the fact and the sexual abuse has already taken place by this point; which is problematic and means that we can only deal with the fallout. There is a growing recognition in the UK & Ireland that although the criminal justice approach is important to respond to cases were child sexual abuse has happened it does not allow us to prevent it or work with at risk populations, victims or perpetrators, in a cohesive way. Additionality, there is a growing recognition that the numbers of registered sex offenders is growing year on year (MAPPA annual report, 2015), that the cost of child sexual abuse is significant (UK, Saied-Tessier, 2014; Fang et al., 2012; Talyor et al., 2008) and that we cannot arrest our way out of online child sexual abuse (The Telegraph, 2014); therefore do we need a change of direction, policy and practice?

One solution that is gaining momentum in the UK, Ireland, Australia, USA, Canada, the Netherlands and Germany (to name a few locations) is a public health approach to child sexual abuse. A public health offers a unique insight into ending sexual violence by focusing on the safety and benefits for the largest group of people possible, meaning that it talks about and to the individual as well as the overall population (Centers for Disease Control and Prevention [CDC], 2004; Laws, 2000; Smallbone, Marshall, & Wortley, 2008; Wortley & Smallbone, 2006; McCartan, Kemshall & Tabachnick, 2014; Tabachnick, McCartan & Panero, 2016). A public health approach involves reframing child sexual abuse from a criminal justice issue dominated by debates grounded in the victim-offender paradigm discussing the personal impact that the offence which gives the impression of isolated and individualised instances of sexual violence, instead moving it to a health issue which involves discussions of a more systematic, embedded culture present in society focused around personal health, societal structures and development (McCartan, Kemshall & Tabachnick, 2014). A public health approach is proactive and is usually based around three levels of intervention;

  • Primary Prevention: Broader approaches that take place before sexual violence has occurred in order to prevent initial perpetration or victimization (e.g., educating parents how to reduce the risk of sexual victimizations in their children). For Instance, Bystander intervention projects, safe touch, upstream.
  • Secondary Prevention: Targeted approaches with “at risk” populations (e.g., providing an anonymous helpline for men who are concerned about their sexual interest in children). For Instance, inform plus, Project Prevention Dunklefeld.

(Centres for Disease Control and Prevention, 2004; Laws, 2000; McCartan et al., 2014; Smallbone et al., 2008)

In the UK & Ireland most of our resources are focused on primary and in particular tertiary prevention; there is a growing recognition that we could invest more in secondary prevention as it would have the potential to prevent the sexual abuse from occurring; therefore reducing victimization as well as the related emotional, psychological and social costs. Some initial findings from the inform plus (Sheath, presentation, NPSCC 2016; Gillespie, Bailey, Squire, Carey, Eldridge & Beech, 2016) and Project Prevention Dunklefeld (Beier, et al., 2009; 2015) While a shift towards a public health approach to sexual harm, epically secondary prevention, is welcomed by both professional organizations (for instance, NOTA, ATSA, NSPCC, Lucy Faithful Foundation, Safer Lives Foundation) there is still a distance to go in regard to national policy, practice and societal support.

The aim of this blog and future prevention blogs on the NOTA website is to highlight the work that is being done in the UK & Ireland, as well as internationally, on child sexual abuse prevention so that we can have an informed, cohesive debate and make sure that it prevention work is moving forward coherently in this arena.

We would be interested to hear your comments in relation to the prevention of sexual abuse by adopting a public health approach. Do you think this is the right approach? Does it over or under emphasise anything? Where should we be heading next in our efforts to prevent sexual abuse?

Kieran McCartan, Ph.D, & Jon Brown, MSc

What Does NOTA Do?

  • Providing a support network for professionals involved in work with, or related to, sexual offending through the national organisation and local branch events
  • Publishing NOTA News, a regular newsletter of articles, information, news and book reviews
  • Publishing a tri-annual Journal of Sexual Aggression jointly with international publishing house Taylor and Francis
  • Developing and extending professional knowledge of sexual aggression, assessment and treatment methods and policy development.
  • Initiating, supporting and disseminating research conducted by NOTA members and others
  • Contributing to practice and policy development, nationally and regionally, through drafting and publishing guidance
  • Organising an annual international professional conference
  • Promoting high quality national and regional training events
  • Publishing briefings and occasional papers on Policy and Practice

Child Sexual Abuse in organisations and institutions

Over recent years we have seen a growing recognition of the problem of child sexual abuse, both historically and non-recent, ranging from sexual abuse by celebrities, institutional child sexual abuse and sexual abuse within the criminal justice system (i.e., the police & prison service); which have resulted in a series of Inquiries in to institutional child sexual abuse in England and Wales (Independent Inquiry into Child Sexual Abuse, the Office for the Children’s Commissioner’s report into CSA ihn the Family Environment), Scotland (Scottish Child Abuse Inquiry), Northern Ireland (Historical Institutional Abuse Inquiry) and Australia (Royal Commission into Institutional responses to Child Sexual Abuse. It is not surprising given what these inquires have suggested, especially the historical ones, that there may be more revelations to come, and indeed three weeks ago with had the revelation of historical Child Sexual Abuse at the heart of Football in the UK.

Continuing revelations, disclosures and conversations of cover up raise a host of questions about the reality of Child Sexual Abuse, the locations of the abuse and the reality of safeguarding in these places. Whether it be about institutions (i.e., Care Homes, etc) or organisations (i.e., the Football Association [FA], BBC, etc) there are a number of commonalities that need to be considered:

  • Safeguarding: All organisations should have safeguarding in place, those working with children and other vulnerable groups; but this must be more than documentation, it needs to be the lifeblood and within the culture of the organisation. The issue is often not that there are not any safeguarding policies or procedures in place, but rather that they are not upheld or badly managed. With regard to the FA they indicate that safeguarding and policy conversations are harder to monitor, as well as uphold, at the amateur levels and we hear that policies are not always put into practice at grassroots level. This results in some institutional recognition of guilt, which is often after the fact, and a recognition that practice needs to change.
  • Prevention: Tied to ideas of safeguarding is the need for work to be done in organisations and institutions to prevent, as well as respond, to child sexual abuse. Quite often the discovery of child sexual abuse results in an institutional response, a change in policy, a criminal conviction and/or an inquiry; however, if we are thinking about prevention being part of the fabric or organisations and institutions then some of this best practice should already be happening. The prevention of Child Sexual Abuse is a growing field but it has clear benefits for organisations and institutions in terms of workforce, development, policy, and practice.
  • Communication: We know from years of research and practice that child sexual abuse thrives in cultures of isolation, where there is poor communication and little transparency. Perpetrators often convince victims that no-one will listen to them, victims are sometimes vulnerable and do not believe that they have anywhere to turn and society thinks that the state (police, social work, prison system and government) do not do enough and when they do engage it does not go far enough. Therefore, theoretically, this means that the more that we talk about child sexual abuse and neglect the more we become aware of it and are better able to navigate, prevent and respond to it. However, it’s not that simple as we do not talk about child sexual abuse consistently and when we do it can be in pejorative terms that reinforces social norms (i.e., “offenders – bad, mad or sick”; “victims – vulnerable, at risk or at fault”; “the state not doing enough for victims and too much for perpetrators”; and “it’s not societies fault or responsibility”) and pushes the blame away, which we have seen not infrequently in the historical child sexual abuse scandals (“there is bad practice and poor safeguarding, but it’s really down to a few bad apples”). We need to think about how we discuss child sexual abuse in our homes, schools, institutions, organisations and society so that the narrative is evident and available there and people feel more free to talk.
  • Disclosure and discussion: The recent FA historical and non recent abuse allegations and disclosures are, as with the care home and institutional ones, particularly salient as they focus on boys and men. Research and practice has indicated that boys and men find it harder to disclose sexual abuse as it impacts their sense of masculinity and may indicate weakness in arenas, like football, were weakness is not tolerated. We need to work with young players to help them realise that disclosure is not a weakness and that they need to come forward and disclose abuse; there have been recent campaigns around this, since the FA allegations came to light a few weeks ago including a helpline and two video campaigns one lead by Wayne Rooney and another by David Beckham. The FA’s quick response to the allegations and historically cases enforces the need to make itself an organisation that puts preventing and responding to child sexual abuse at its core; similar to what the NFL has done around domestic violence and sexual assault.
  • Vulnerability: The conversations that have started to emerge from historical institutional child sexual abuse discussions have highlighted the degree of vulnerability of the victims. This vulnerability can be deeply ingrained in them because of their social class, culture, mental health of mental capacity; but it can also be situational, as has been seen in the recent FA disclosures, were victims talked about wanting to progress, to succeed and to move on and getting close to (as well as pleasing) the coaches was a way of doing this. The vulnerability that children experience can make them a target, or at least more susceptible to child sexual abuse by individuals who recognise and want to use that vulnerability. This reiterates the need for confident, trained and responsive organisations and intuitions that are able to identify, prevent and respond to signs of child sexual abuse when they present themselves at the earliest opportunity.

Although, the focus of the conversation is currently centred on football it seems like it may be only a matter of time before this crosses into other sports, nationally and internationally. We as a society need to recognise that we have to be able to work to prevent child sexual abuse, as well as respond to it, in a proactive way that sufficiently safeguards children, and opens up communication in a proactive fashion to discussions about how can all play a role in protecting children and in preventing abuse and exploitation. We could say that “child sexual abuse in football, just another example of a few bad apples slipping through the net” or we have the opportunity to be more proactive and recognise that child sexual abuse is a more endemic problem in all our communities and in many of our institutions and we have now have the opportunity to refocus our efforts on prevention and early intervention and on ensuring that the victims, survivors and those who have caused the harm get the help they need.

Kieran McCartan, PhD, & Jon Brown, MSc.

Balancing the books? Starting to understand the reality of sexual harm in the UK

A recent report from the Crown Prosecution Service [CPS] for England and Wales shows an upturn in reporting, recording, prosecutions and convictions in sexual harm [including, Rape, Child Sexual Abuse, Prostitution, Honour Based Offences, etc.] for the year 14/15 for women and girls. Although the report indicated that the largest increases were for women and girls as victims of sexual harm and for males as perpetrators, it does also show that there was an increase for men and boys as victims as well as for females as perpetrators too. The data came from the CPS case management system, which means that the results and analysis were based upon what was recorded by CPS staff via the existing databases and systems.

The report signals that:

–          The volume of referral’s to the CPS for Sexual Abuse, Domestic Violence and Rape decreased by 3.3% to 124,737 compared to 14/15;

–          The volume of individuals charged with Sexual Abuse, Domestic Violence and Rape by the CPS increased by 0.5% to 86,067 compared to 14/15;

–          The volume of individuals prosecuted by the CPS for Sexual Abuse, Domestic Violence and Rape increased by 9.8%, to 117,568 defendant’s, from 14/15 to the highest level ever recorded; and

–          The volume of individuals convicted of Sexual Abuse, Domestic Violence and Rape also rose by 10.8%, to 87,275, from 14/15 to 87,275 in 15/16, to the highest level ever recorded.

The main take-home message from the report is that the volume of prosecutions and convictions across the violence against women and children spectrum is the highest that they have been over the last nine years that the CPS has been recording them in this fashion and that new, as well as relatively new, offences (e.g., Female Genital Mutilation, Honour Based crimes and revenge porn offences) have shown increasing referral’s, charges, prosecutions and convictions. The report highlights, what we have often suspected, that the rates of sexual harm and violence against women and children do not match the reality of sexual harm in society. However, it’s important to put these findings into context as we need to recognise that 15/16 was not necessarily a peak year for sexual harm, but rather that it is an indication of a turning tide in society;

–          There seems to be a growing trust in the Criminal Justice System epically the police; the public seems to be more willing to report crime and seek prosecutions.

–          An increased awareness of violence against women and children in society because of high profile media cases, the IICSA investigation and a series government reviews (inc, prostitution, hate crime, etc).

–          Updates and changes to crime recording (including, the recording of new crimes and a change in terminology in existing ones) means that some offences may have not been recorded previously, or if they had been recorded they may have been recorded in a different category.

–          A review of sentencing guidelines for sexual offences.

–          The increase in historical sexual harm offences being reported and processed by the police, CPS and Courts.

–          A commitment from the CPS to offer more support to victims of sexual harm, with the former Prime Minister calling  sexual abuse a national threat.

–          An increase in funding to understand, prevent and respond to FMG, honour-based violence and trafficking from the UK government.

This highlights a commitment from the Criminal Justice System in England & Wales and UK government to respond to sexual harm, and related offences, resulting in increased reporting, recording, prosecutions and convictions. The increase revealed by the CPS report is not surprising given the under-reported nature of sexual harm and starts to help us understand the nature of these offences in society; the take-home message seems to be the more we talk, the more we see and the clearer picture we get. Therefore it’s not so much an increase, potentially, but rather a reality check and call for more preventive work and public/societal engagement work to be done.

Which ties directly into the work of NOTA and are all issues that will be discussed at its upcoming conference (Annual NOTA conference, Brighton , 28th – 30th September 2016) and a FREE  Public Engagement event (6 – 7.30PM, Brighton Metropole Hotel, 28th September, 2016).

Kieran McCartan, PhD


NOTA International Conference 2016

Brighton Conference 2016

NOTA’s 26th Annual International Conference in Brighton, September 2016 promises to be
yet another exceptional event with 3 overseas speakers and 4 experts from the UK addressing key issues which confront practitioners, managers, therapists, researchers, policy makers, academics and trainers in their everyday work, as well as an exceptional and diverse range of breakout sessions. Full details are in the online programme.


Lets_Talk_sexual_thumb This FREE PUBLIC EVENT is part of the NOTA 2016 Conference.

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To register please follow –

What is Nota?

NOTA is the National Organisation for the Treatment of Abusers, and is a registered charity. Inaugurated as a National Organisation in 1991, NOTA grew from a regional network in the North West of England. Membership is open to any professional whose work concerns intervention with sexually aggressive individuals regardless of their age, race, gender or sexual preference. With a growing multi-disciplinary membership comprised of practitioners, managers and policy makers from the public, private and voluntary sectors, NOTA is able to bring a wide variety of perspectives to intervention with sexual aggressors.

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NOTA Annual Conference, Brighton 2016

The annual NOTA conference took place from the generic cialis 28th – 30th September in Brighton, this year’s theme was “Sharing Practice and Research: Coming together to become more effective”; however, the underlying theme and narrative of the conference was about the prevention of sexual abuse. The conference was a real mix of research, practice and engagement with colleagues, as well as the general public. In this blog I am going to take you on a whistle stop tour of the event.

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The 2016 plenaries combined research, practice and innovate approaches from a very international group of speakers. The plenary sessions covered a range of topics including from online behaviour and Child Sexual Abuse (David Delmonico, Andy Phippen), mental health and sexual offending (Jackie Craissati), the treatment of sexual abusers (Gwenda Willis; Clark Baim), the work of the Independent Inquiry into Child Sexual Abuse (IICSA) (Stephen Webster) and international approaches to sexual abuse prevention (Maia Christopher). Although these plenaries were on different topics, and from a national to an international viewpoint, they all talked to the reality of child sexual abuse and how we as individuals, professionals and a society could prevent it.

The workshops spanned a full range of topics including: Circles of Support and accountability (Martin Clarke and Kerry Earnshaw; Tracey Blackstock; Kieran McCartan Rebecca Milner); public health approaches to sexual abuse and prevention (Stephen Smallbone; Gwenda Willis; Kieran McCartan; Jon Brown); child sexual abuse material and online offenders (Danielle Kettlebrough; Daryl Mead and Mary Sharpe; David Delmonico; Vicky Young and Tom Squire; Marcella Leonard); youth who sexually harm (Pat Brangan; Susannah Bowyer; Simon Hackett; Valerie Sheehan and Eileen Kilpatrick; Helen Whittle; Kathryn Lawrence; Carlene Firmin); female sexual offenders (Andrea Darling); treatment (Clark Baim and Lydia Guthrie; Jacqueline Page), as well as risk assessment and policing (Marcella Leonard; Duncan Sheppard). The workshops were a good mix of research, evaluation, practical working, professional learning and knowledge exchange.

In addition to the traditional conference activities NOTA 2016 also had a series of special interest activities and bespoke sessions. The conference hosted NOTA’s second public engagement event which did not have many members of the public (a real learning point for NOTA 2017 and a different experience to NOTA 2016) but instead welcomed 30+ conference attendees (academics, stakeholders, professionals and therapists from across the UK and beyond to discuss how we can prevent Child Sexual Abuse. The session heard from national (Nina Burrows; Kieran McCartan) and international (Maia Christopher) speakers about the work that they were involved with in preventing child sexual abuse and their ideas for where NOTA and professionals in this arena go next. Interestingly, in the Q & A afterwards there was not consensus between the audience and panel, or even the audience themselves, that we have got prevention correct, that we are using the right language, hitting the target audience and that we as a professional body main need to do more amongst ourselves before moving into working with communities.

NOTA also had a session on the systematic review that the organisation was involved in around the development of the new NICE guidelines (Fiona Campbell and Simon Hackett) relating to assessment and treatment of youths with involved in sexually harmful behaviour. The conference also had the head of research from the IICSA (Stephen Webster) come and talk about the progress of the research strand and talking about some of the early projects and rapid evidence reviews (especially on the church, sex offenders with Learning Difficulties), in closing Stephen though that there was a lot more research to do and had a desire to link the IICSA work to that of the Royal Commission into institutional responses to sexual abuse just concluding in Australia. Last but not least NOTA held its first student event, which was an opportunity for students to meet there contemporaries in the field to discuss their research. NOTA 2016 fitted a massive amount of material in across three days, which left me informed, refreshed and looking forward to next year’s meeting in Cardiff (20th – 22nd September 2017).

Kieran McCartan, Ph.D