Rehabilitation in culture and practice or simply in ideology?

By Kieran McCartan, Ph.D., David Prescott, LICSW, Kasia Uzieblo, Ph.D.

One of the authors (Kieran) was teaching about the politics of risk management in the criminal justice system this week. The class focused on the balance between punishment and rehabilitation/treatment. We know that the role of the criminal justice system is to provide punishment for offenses committed and also to provide the opportunity for rehabilitation so that the individuals in question can be integrated back into the community post-release. However, we also know that it’s not that simple, that there are different pressures on the criminal justice system that force it more towards punishment than rehabilitation, or (rarely) vice versa. Finally, we know that tools intended for rehabilitative purposes (e.g., risk assessment) are applied to provide punishment instead. Although the balance of punishment and rehabilitation is at the root of important debates, the broader debate has gone on for ages, with little really getting resolved. The results are commonly an agreement that things need to change, with an acknowledgment that they rarely do.

An interesting point in these debates is that we use terms like rehabilitative culture to explain what we do, but the question that we need to ask ourselves is that whether we are really building a culture or more of a hat tip to the idea of it. When we think about culture, we think about a system, a way of doing things that happens in unison with a common purpose. However, in criminal justice, this rarely happens; we often have a gap between ideology and practice, a gap between the way that we want to do things and the way that we are doing things. If we are honest, we also have a gap between how we portray our rehabilitative cultures and the less pleasant realities when we ask the service user’s experiences.

This “rehabilitation gap” often reflects economics, politics, public and professional attitudes, and the media (to name a few) that push policy and practice as well as ideology and implementation further apart. Ideal terms, such as “rehabilitative culture” should reflect values such as a commitment to all aspects of the service users’ journey towards successful rehabilitation and community reintegration. However, what we are often left with is a process-driven form of rehabilitation that strives for a cultural underpinning but does not really achieve it; as we’ve seen, many factors can intervene. It is important to note that true rehabilitative culture is a hard thing to achieve and is a practice and a discipline. A bit like a therapeutic community it needs buy-in from everyone and cannot work in a piecemeal fashion.

Is there a difference between a culture that works towards rehabilitation as opposed to a rehabilitative culture? We believe there is. The implications are that we must recognize that our current practices process and outcome-driven without necessarily being culturally embedded. If we want a rehabilitative criminal justice system, we need to be service user-informed, evidence-based, and practice-led. We need to untangle rehabilitation from punishment and look at them as two parallel, interrelated but distinct processes. We have started to do this, but in our review of programs, practices, and policies it often seems that we have a long way to go. In our view, punishment in the absence of opportunities for rehabilitation is cruel.

Questions for front-line professionals might include:

· Does your work setting have a clear mission statement that staff members take to heart?

· Do your clients have a clear understanding of how your treatment completion, rehabilitation, and community reintegration? In other words, do they know what the end of treatment looks like?

· Has your work setting explicitly defined what a rehabilitative culture looks like and how it operates?

· Has your work setting actively sought out the feedback of clients receiving care? Do they agree with your vision of a rehabilitative culture and how it exists in your program?

· Does your work setting have a track record of responding to client feedback? Many agencies collect feedback but do not circle back to tell their clients what changes they are making in response to that feedback.

Anyone who has read the news at all in the past several years will know that no form of culture can ever be taken for granted.

Sibling sexual abuse: A knowledge and practice overview

By Stuart Allardyce, Director Lucy Faithfull Foundation.

To find out that your child has sexually abused his or her sibling is one of the most disturbing experiences a parent can live through. As a social worker I once worked with a mother who described finding out that her 8 year old daughter had been sexually assaulted by her 13 year old step-brother as being ‘like a grenade going off in the heart of my family’. Over the last 20 years I’ve worked with countless families that have been torn apart by this form of intra-familial harm. Working with such cases never gets easier; it always involves having to connect with parents and with children who are going through immense pain, confusion, distress and shame.

And for those of us who work in child protection and safeguarding, these situations are – tragically – not uncommon. Although sibling sexual abuse is less likely to be disclosed in childhood than other forms of sexual abuse and exploitation, it is the most common form of intra-familial sexual harm, with victimisation studies suggesting it may be three times as common as sexual abuse by a parent. If you work in any aspect of child care, you are likely to work with a family that has been impacted by sibling sexual abuse at some stage. If you work with adult survivors of child sexual abuse, it’s also likely to be an issue you regularly encounter in your practice. Many only feel able to disclose in adulthood – if at all – as they reflect on childhood experiences from the perspective of adulthood.

Research also tells us that the response families get from professionals they work with after sexual abuse can sometimes be inconsistent, confused, and not sufficient. Key decisions need to be made at this stage in relation to whether siblings can continue to live together or need to be separated, as well as about what assessment and intervention approaches would be helpful for the child who has been harmed, the child who has harmed and the family as a whole. These decisions need to be grounded in evidence and an understanding of the best practice, as well as being responsive to the needs of the family and all of its individual members. Decisions made also demand practitioner reflectiveness, recognising your own values, feelings, and preconceptions, supported through knowledgeable and sensitive supervision.

These are the reasons why my colleague Peter Yates and I were asked to write a report by the Centre of Expertise on child sexual abuse (CSA Centre.) This was published last week and provides an overview of current research and practice knowledge on sibling sexual abuse in childhood. The report (https://www.csacentre.org.uk/knowledge-in-practice/practice-improvement/sibling-sexual-abuse/) is designed to be an accessible resource to help professionals think through the issues and challenges raised by this form of familial abuse.

Our starting point in the report is language. You might have noticed I referred to the ‘child who has been harmed’ and the ‘child who has harmed’ earlier in this blog. Clunky terminology, but to use the language of ‘victim’ and ‘perpetrator’ brings an adult lens to this issue that instead needs to be considered in a developmental and familial context. That’s not to minimise the significant harm caused by this kind of abuse or to excuse abuse in any way. Studies that have compared young people who have displayed harmful sexual behaviours within family contexts and outside family contexts have found that the former group is more likely to abuse the child who has been harmed through penetrative acts, repeatedly and over extensive periods of time. Clinical studies suggest theaverage age difference between siblings is three to five years. This is a form of sexual violence that urgently needs to be tackled. But we also need to recognise that these are children first and foremost in these cases, and that needs to be the starting point of our work.

The report covers the identification of abusive sibling sexual abusive behaviours and how these contrast with sexual behaviours between siblings that are developmentally normative and exploratory, as well as understanding that some sexual behaviours between siblings may be inappropriate or problematic but not abusive per se. All front line safeguarding practitioners need this kind of information.

The report also looks at what research tells us about those who harm and those who are harmed, in such situations and the common issues for families. But the heart of the report is what evidence tells us about how we initially respond to such situations, what should inform key decisions about family safety, and what research tells us about defendable approaches to assessment and interventions.

This is a subject that is slowly emerging as a theme in safeguarding practice. Our hope is that the report contributes to better outcomes for children and their families and has a role to play in ensuring professionals feel supported in knowing what to do when responding to families when this issue is identified. But remember, prevention is always better than cure, and we hope that this report may also be a starting point for reflection on what we need to do as professionals to reduce risks and increase protective factors in families through primary and secondary prevention that might contribute to sibling sexual abuse never happening in the first place. We are currently working on a practical resource, as commissioned by the CSA Centre, to further accompany this evidence review and form the next step in this journey. To find out more about the work they do, read further resources and access the report, do visit: www.csacentre.org.uk