By Kieran McCartan, David S. Prescott, LICSW & Katherine Gotch, LPC
The field of sexual abuse continues to embrace a prevention narrative and its real-world application. Although the sexual abuse prevention narrative has traditionally focused on the prevention of reoffense (tertiary prevention – see below) or providing broad-based community/societal messages (primary prevention), there has been a focus more recently on the development of services for populations at risk of offending (secondary prevention), as well as considerations regarding the role of effective risk management and safeguarding practices after conviction to ensure our interventions themselves do not cause harm (quaternary prevention).
A major challenge in the prevention of sexual abuse is not in the framing, which is appropriate and fit for purpose, but rather the development of the evidence-base and its practical, real-world application. People and policy makers recognise that prevention of abuse is better than after-the-fact responses as prevention results in no more victims. However, prevention also creates complicated (and some would even argue, complicit) narratives around people who commit sexual abuse as prevention efforts are offered from a holistic, life-course perspective. This requires communities, individuals, and policy makers to acknowledge the complexities inherent within the perpetration of sexual abuse, something which is especially difficult within legislative systems which often require black and white solutions to complex problems. Some have also felt that a holistic, life-course perspective is used to justify and explain away sexual abuse, which is not the case at all! Prevention efforts become more effective when they are based in solid knowledge about those who abuse and this information is then incorporated within all levels of prevention. There is more to preventing sexual abuse than tick-box criteria of adverse experiences, past trauma, mental health issues, and poor socialisation – effective prevention efforts recognize the impact of contextual factors on the antecedents of sexual abuse and emphasize knowledge about how interventions can be most effective at different points to stop abuse from happening at all levels. It is about incorporating what we now know regarding the aetiology of offending and embracing the importance of recognizing warning signs, talking about problematic behaviour and developing healthy lifestyles, including support systems, that lead to effective prevention efforts.
Preventing sexual abuse is also about effective risk management, either by the individual themselves or in conjunction with their families/peers or a third party if needed (e.g., probation, parole, counsellor); however, we do not often frame the prevention of sexual abuse in risk management terms. Risk management is often seen as a punitive, controlling and restrictive standpoint – something that is done to an individual rather than with an individual. However, as research and practice have shown over the years, the effective reduction in reoffending or the curtailing of first-time offending is most successful through a partnership among stakeholders and with buy-in from the individual in question. To this end, we offer that effective risk management neatly sits within the public health prevention framework and should adhere to the socio-ecological model of prevention:
|Primary||Raise public awareness of the reality of sexual abuse and dispel common myths about victims and preparators. Which enables individuals and communities to be better at identifying sexual abuse, risky behaviors and be better able to support people impacted by sexual abuse. Increased education leads to increased awareness and more proactive behavior. For instance, public education campaigns, bystander intervention, Eradicating Child Sexual Abuse, etc.|
|Secondary||Enabling “at risk” populations to understand their potential risks, triggers and the potential outcomes of them. This means that they can seek appropriate support and be empowered to seek help. Individuals and communities better understand risk and therefore are better able to help people manage their own (potential) risk. For instance, Project Prevention Dunkelfeld, Stop SO, Safer Living Foundation, Lucy Faithful, Help Wanted!, Stop It Now!, The Global Prevention Project, etc.|
|Tertiary||Working with people convicted of sexual offences to hold them accountability for their past problematic behaviour, get support and move forward, integrate back into their communities. These interventions move people towards an offence free lifestyle and encourage desistence. They help people manage their own risk (i.e., treatment programmes and interventions). For instance, treatment programmes and interventions for people who have committed sexual abuse, etc.|
|Quaternary||This enables people to successfully integrate back into the community by protecting people from collateral consequences or risk management policies and practices. This is done through supportive integration programs that help the person who has sexually abuse, aid their re-entry and support them pro-actively to negative the range of policies and practices that negate their integration. For instance, Circles of Support and Accountability (UK, Circles 4 EU, Canada, & USA), etc.|
For risk management to work as an effective prevention strategy, it requires a foundation in the socio-ecological model that is complemented with multi-agency and multi-disciplinary collaboration in conjunction with individual involvement. Prevention is most effective and impactful when all aspects of our knowledge are incorporated into a holistic approach to understanding sexual abuse which includes risk management strategies such as the individual knowing their risk and how to manage that risk both pre and post offending.