Prevention programmes aimed at carers need to look beyond awareness raising and confidence building
By Mike Williams, NSPCC
Prevention programmes aimed at family members are big business these days. Sexual abuse prevention programmes, in particular, have a history stretching back to the 1970s in the United States of America, where they were first developed. The first programmes were delivered to children, and in the 1980s they were extended to parents. Programmes delivered to parents take the form of one-off meetings, two to three hours long. Programmes aim to increase knowledge, improve attitudes and intentions, increase carer communication with children about abuse and improve behaviours believed to reduce risk. Programme effectiveness is determined by measuring user change against these outcomes.
Although helping carers to improve knowledge, attitudes, communication and behaviours is laudable, it is questionable as to whether achieving these outcomes reduces the likelihood of children being abused. The use of these outcomes as indicators of programme effectiveness rests on several questionable assumptions:
- Gains in knowledge and attitudes lead to behavioural change.
- Carers’ reported increases in desired behaviour are accurate.
- Changed behaviours effectively lower likelihood of abuse.
Evaluation of prevention programmes targeted at children suggest these assumptions do not always hold, that is to say, positive programme outcomes do not necessarily lead to a reduction in abuse. Increases in correct verbal responses do not always lead to an improvement in behavioural response. Using learned self-protective behaviours to guard against threats or attempted assault does not always impact on whether abuse occurs. Children who understand prevention messages can go on to be sexually abused.
Could it be, therefore, that prevention programmes are missing a vital piece of the jigsaw? Could it be that prevention programme organisers have failed to understand the challenges to identify and lower risk?
A recently published report on work done to support mothers lower risk in the home suggests the answer to both of these questions is yes. The work was done with Somali mothers but the findings are applicable to female carers across communities and to a lesser extent, male ones. The report has identified a number of issues that prevention programme organisers, focused on informing mothers about abuse and prevention behaviours, should attend to:
- Mothers need to be persuaded that their children may be at risk of abuse, not just informed. Getting people, with whom mothers can identify, to recount personal stories of abuse is a good method of persuasion.
- The journey towards identifying risk in the home is an emotional one, not just an intellectual one. Some mothers may find contemplating the risk of abuse and discussing the issue with family members sufficiently distressing that they cannot accept the possibility of abuse. In these cases, they may require one-to-one counselling to effectively address the issue.
- Mothers need to find a way of accepting the possibility of abuse in their community, family and home while maintaining a sense of pride and respect for these same things. It could help to introduce the idea that while communities have values and standards, not everyone chooses or is capable of meeting them.
- Mothers considering the possibility of abuse, like mothers handling disclosures of abuse, experience ambivalence about whether abuse can happen. Successful acceptance of the possibility of abuse may require programme organisers to give mothers the space to express and work through their ambivalence.
- Mothers may accept the possibility of abuse without attempting to assess the actual risk posed to their children. They may need encouragement and support to carry out such an assessment, and support to ensure that the assessment is accurate.
- Mothers may identify areas of risk, without feeling able to safely negotiate and lower that risk. They may need support to think about how they can either discuss the issues safely or sidestep explicit discussion and find indirect ways of effectively lowering the risk. They may need support to deal with the fact that there is no easy or safe way to lower the risk.
- Part of the distress experienced by mothers when contemplating discussing the issue of abuse with family members is a fear of the consequence of breaking with expectations that women should not discuss sexual matters or question the integrity of men. Helping mothers protect their children may be facilitated by campaigns directed at men and women to effectively challenge community attitudes on what is acceptable for women, men and children to discuss.
In short, while the traditional focus of prevention programmes on improving knowledge, raising confidence and increasing communication with children may make the difference in some cases, where programmes do not work with carers to address the perceptual, emotional and social barriers to identifying risk and taking action, they risk failing some children. Supporting carers in identifying and overcoming the challenges is likely to be more resource intensive than a blanket information campaign, but it may turn out to be a more effective, and therefore a more cost-effective method of preventing abuse.
This blog article relies on research and evidence that is referenced in the full report, which you can read here: https://learning.nspcc.org.uk/media/1547/four-steps-to-the-prevention-of-csa-in-the-home.pdf
You can read a report on how the programme organisers worked with the Somali community in a collaborative fashion to develop the work with mothers here: https://learning.nspcc.org.uk/media/1546/working-with-community-to-prevent-csa-in-the-home.pdf