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Working with the Victims and Perpetrators of Child Sexual Abuse and Exploitation Working with the victims and perpetrators of child sexual abuse and exploitation is one of the most challenging fields of child protection practice. The nature of some of these cases is such that it challenges our beliefs in the inherent goodness of our fellow human beings and can leave us, as practitioners, feeling emotionally drained and bruised. In the words of a participant in one of the research studies reported in this issue of Child Abuse Review, ‘It's horrible stuff that you are hearing day in and day out’ (Ahern et al., 2017, p. 133). These cases are often complex and their investigation can be protracted. There is a difficult balance to be achieved between the forensic requirements of robust evidence gathering, the therapeutic aspects of caring for the victims, and the public interests of ensuring justice, rehabilitating offenders and preventing reoffending. So how can we best support professionals working in this complex field? What tools and techniques are available to them and how best can they use these? The papers in this issue of Child Abuse Review address some of these topics.

Understanding Offenders' Belief Systems

We start with the offenders and a discussion paper by Jamie Walton and colleagues (2017) looking at the properties of the Sex with Children scale. This assessment tool was developed in the 1990s and is widely used within the prison service in England and Wales to measure pro-offending attitudes in offenders who participate in the national Sex Offender Treatment Programme. Reviewing the published literature on the Sex with Children scale, Walton et al. found that it has good reliability compared to other assessment tools, but some recent research suggests that its predictive power for sexual and violent reconviction is no better than chance. This questions the tool's validity and usefulness within the management of child sexual offenders. In order to explore this further, Walton et al. appraised the scale in the light of the Implicit Theories hypothesis.

‘One of the most challenging fields of child protection practice’

‘How can we best support professionals working in this complex field?’

‘Research suggests that its predictive power for sexual and violent reconviction is no better than chance’

*Correspondence to: Peter Sidebotham. E-mail [email protected]

Editorial Peter Sidebotham* Warwick Medical School, University of Warwick, UK

Child Abuse Review Vol. 26: 85–90 (2017) Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/car.2467

Theories about Theories

One of the privileges and challenges in editing a journal such as Child Abuse Review is that you are often forced to step beyond your area of expertise and knowledge and embark on a journey of discovery. Such has been the case for me in relation to the Implicit Theories hypothesis (Ward and Keenan, 1999). In essence, this theory was put forward by Tony Ward and colleagues as a way of trying to understand the belief systems of child sex offenders. Ward and colleagues postulated that such offenders may hold one or more ‘implicit theories’ about themselves, other people and their surrounding environments, and it is these inherent belief systems which allow them to sexually abuse children. They proposed five implicit theories that child sexual offenders may hold: children as sexual beings; the nature of harm; the world as dangerous; entitlement; and uncontrollability (Ward and Keenan, 1999). The first two of these focus on the victim and can be considered specific to

the sexual offences against children. Those offenders holding to the ‘children as sexual beings’ implicit theory perceive children as sexual beings who are able to provoke adults into sexual interaction; offenders who hold this belief may misinterpret innocent childhood behaviours as being sexually inviting. In relation to ‘nature of harm’, offenders see sex as positive and therefore not harmful, and potentially even beneficial to children; offenders may therefore see sexual activity as a child's right and that they are acting in the child's interest in engaging in sexual interaction. One of the difficulties with measuring these two theories is that, while they may hold such beliefs, offenders may also recognise that others hold such beliefs as wrong, and therefore may hide their true beliefs, answering questions in a socially desirable manner. Indeed, Walton et al. (2017) found in their review that offenders rarely agreed with such items outright, but rather disagreed with them less strongly than non-offenders. Two of the implicit theories in Ward's schema focus primarily on the

offender. Within the ‘entitlement’ implicit theory, offenders see themselves as somehow superior to others and that they are, therefore, entitled to have sex with whoever they want, whenever they want. ‘Uncontrollability’ refers to the belief that sexual urges are strong and beyond the individual's control. The final implicit theory, like the previous two, is less specifically linked to

child sexual offences. This theory relates to how the offender sees the world: as a threatening, dangerous place, in which other people are untrustworthy. Sexual offences can therefore be seen as a reaction to a threatening world, a means of establishing dominance or control, or of feeling safe. In relation to children, this implicit theory may be further developed to portray children as less threatening than adults and therefore a source of security in an otherwise dangerous world. In their paper, Walton et al. (2017) highlight that the Sex with Children scale

only measures the first two, sexual offence-specific implicit theories, and, in keeping with most other assessment tools, does not measure the more generic implicit theories. The authors suggest that this limits the utility of the scale as a predictive tool. They argue that ‘Nonsexual schemas may promote a general antisocial orientation which is an important factor predictive of recidivism in

‘Five implicit theories that child sexual offenders may hold’

‘The Sex with Children scale only measures the… sexual offence- specific implicit theories’

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some offenders’ and call for further work to update the scale so that it assesses nonsexual as well as sexual implicit theories (p. 99). In their original paper on implicit theories, Ward and Keenan (1999) pointed out that their hypothesis is just one way of trying to understand the cognitive beliefs of child sexual offenders, and that there are numerous other perspectives which are equally important in trying to understand and work with such offenders. They do stress, however, that an understanding of these implicit theories is central to any effective work with offenders, and that treatment is likely to require the challenging and restructuring of these theories. In light of this, Walton and colleagues' call for updating the Sex with Children scale seems particularly apposite.

Responding to the Child Victims of Sexual Abuse

Our next papers turn to the child victims of sexual abuse and how we can assess, support and respond to their needs. In Scotland, as in the rest of the UK and elsewhere, best practice in gathering information on alleged sexual abuse is through a joint investigative interview involving specially trained police officers and social workers. Specific guidance exists for such interviews and they depend on a high level of communication skills. In response to concerns that interviewers may not, in fact, be following the

guidance, Susanne Goetzold (2017) conducted a well-designed evaluation of joint investigative interview training in Scotland. This included both a self- evaluation by participants and a content analysis of transcribed role-play interviews. Disappointingly, she found that while the participants had a high level of perceived competence in relation to their preparedness to carry out investigative interviews, this was not backed up by the empiric findings from the recorded role-play interviews. Two aspects in particular seemed to be lacking from the role-play interviews: the use of ‘practice interviews’ in helping to establish rapport and prepare the child or young person for the interview; and allowing space for free narrative through the use of open questioning and non-directive prompts. Although ‘practice interviews’ are stipulated in the Scottish guidance and

have been shown to improve the flow of free narrative information from the child, only two interviewers attempted to conduct a practice interview during the role-play. In relation to the use of free narrative, the findings were equally stark: the free narrative phase of these interviews lasted on average just one minute and four seconds (out of an average 22-minute interview). In contrast, specific questioning by the interviewer lasted an average of 14 minutes and 40 seconds. There was considerable evidence of closed questions being used by the interviewers, and none of the interviews provided evidence of the child being encouraged to tell the whole story before being asked specific questions. Typically, interviewers were very directive, tending to follow up each piece of new information provided by the child with specific questions, while questioning styles were ‘often very direct and fast-paced, thus not giving children time to search their memory and formulate responses’ (Goetzold, 2017, p. 124). Whether or not these findings would be replicated in actual practice of joint

interviewing would require a further study. Nevertheless, if such approaches

‘An understanding of these implicit theories is central to any effective work with offenders’

‘A well-designed evaluation of joint investigative interview training in Scotland’

‘None of the interviews provided evidence of the child being encouraged to tell the whole story before being asked specific questions’

87Editorial

are being used in role-play interviews in the context of a training programme specifically focusing on interviewing technique, it suggests that the right approaches are not being well adopted. This could have a significant impact on the quality of evidence obtained during the interviews, on the young person's ability to tell their story, on their perception of the interview and potentially on their recovery from the trauma of the abuse. The impact of interviewing style on children's disclosure has been picked up

in a previous review article by Rosaleen McElvaney (2015) in Child Abuse Review. She found evidence that ‘interviewers responded to less communicative children by increasing the proportion of closed questions which in turn led to children being less forthcoming’ and that

‘the use of a protocol that emphasises the use of prompts that elicit free narrative (e.g. ‘tell me about that’) as compared with closed questions (those requiring a yes/no response) has resulted in more detail and more accuracy in children's accounts’ (McElvaney, 2015, p. 162).

Building on some of this earlier work, we publish a new study by Rosaleen McElvaney and Maebh Culhane (2017) comparing the information obtained from young people in a direct research interview with that available as a result of the child protection assessment. The motivation for this piece of work came from wanting to minimise the

harm to children through repeated questioning about traumatic experiences, while still wanting to allow their voice to be heard in research. As Houghton (2015) pointed out in her paper on participatory ethics, young people have a right to participate in research and so contribute to the extension and use of knowledge in ways that affect them. Far too often, however, children and young people are not even given the opportunity to participate in research and so their voices are excluded. McElvaney and Culhane (2017) therefore sought to determine whether the use of information routinely collected during an investigation could replace that obtained through a direct research interview. The authors compared the information contained in assessment reports of 39 children seen in a child sexual abuse unit with direct research interviews of 22 of those children. They found that the assessment reports contained a wealth of data on the nature and duration of the abuse, the children's relationship to the abuser and on factors that influenced their disclosure. Not surprisingly, they found that all these themes were more common in the research interview data, but that many of the assessment reports contained information that was not elicited in the research interviews, and vice versa. A number of important conclusions can be drawn from this research:

first, that we owe it to children and young people to include their voices in research about and for them; second, that much useful data can be obtained through the careful and ethical use of routinely collected information, such as case assessments; and third, that routinely collected information cannot replace the depth and breadth of data obtained through well-designed qualitative or quantitative research projects. In seeking to promote evidence-informed research, therefore, we need to explore both avenues and to do so in a way that respects and empowers children and young people.

‘Comparing the information obtained from young people in a direct research interview with that… of the child protection assessment’

‘We owe it to children and young people to include their voices in research about and for them’

88 Editorial

Supporting Practitioners Working with Child Sexual Exploitation

Our next paper by Elizabeth Ahern and colleagues (2017) explores the experiences of police officers and social workers working with cases of child sexual exploitation. The researchers interviewed 15 practitioners about their experiences. While the practitioners reported that the cases were emotionally taxing and challenging to deal with, almost without exception, they tended to focus on the victims' emotions during interviews, often suppressing or ‘switching off’ their own emotions. Practitioners would make practical and intellectual preparations for interviews, for example, by researching the cases, but would rarely prepare themselves psychologically. Following investigative interviews, practitioners would often rely on informal opportunities for debriefing or support. One of the striking findings of this research was the tendency for

practitioners to report withholding their own emotional responses during the interviews for the sake of the young people. However, as the authors point out, many young people want practitioners to be human and interact with them. Such emotional distancing could have a negative impact both on the young people themselves and their ability or willingness to engage with the interview, and also on the wellbeing of the professionals involved.

The Complexities of Researching the Prevalence of Child Maltreatment

Our final research paper in this issue is a fascinating piece of work by Mariëlle Prevoo and colleagues (2017) from Leiden University. This research team has previously undertaken a meta-analysis of research from across the world on the prevalence of child maltreatment (Stoltenborgh et al., 2015). They had found considerable variation between studies in the reported prevalence of different forms of maltreatment. In the current extension of that work, the researchers have carried out a number of further analyses to examine the influence of different methodological moderators on the findings. They found significant effects on the reported prevalence depending on participant characteristics, the sampling procedures used and the approaches to definition and measurement. The authors provide a helpful diagram summarising some of the key influences on recorded prevalence, however, the overall picture is far more complicated, with the effects and even the direction of effect being different for different types of maltreatment. This paper is important reading for all researchers and policymakers

attempting to study or interpret the results of the prevalence of different forms of child maltreatment. As the authors point out,

‘the true lifetime prevalence of child maltreatment is hard to estimate, and perhaps impossible to measure, but knowing which factors influence the results of prevalence studies can help us to get as close to the actual lifetime prevalence as possible’ (Prevoo et al., 2017, p. 156).

This, in turn, may help in setting the direction and monitoring the impact of safeguarding policies. We finish this issue with two book reviews of relevance to practitioners.

William Meredith (2017) reviews Recognition of Child Abuse for the

‘Tendency for practitioners to report withholding their own emotional responses during the interviews for the sake of the young people’

‘Important reading for all researchers and policymakers attempting to study… the prevalence of different forms of child maltreatment’

89Editorial

Mandated Reporter by A. P. Giardino and colleagues: ‘a comprehensive literature review on the various types of abuse, how to spot them and how they can be treated/prevented’ (p. 158). Katy Burch (2017) reviews Kim Holt's book, Contemporary Family Justice: Policy and Practice in Complex Child Protection Decisions. Burch comments that the book ‘effectively highlights ways in which the introduction of Public Law Outline processes has, in spite of its laudable goals, impacted negatively on aspects of justice for both parents and children where there are child protection concerns’ and explores other ‘potentially corrosive influences on current family justice and decision- making’ (p. 159). This suggests that the book will be important reading for all those involved in policy and planning around family justice.

References

Ahern E, Sadler LH, Lamb MEL, Gariglietti G. 2017. Wellbeing of professionals working with suspected victims of child sexual exploitation. Child Abuse Review 26(2): 130–140. DOI:10.1002/car.2439.

Burch K. 2017. Book review of Contemporary Family Justice: Policy and Practice in Complex Child Protection Decisions by Kim Holt, Jessica Kingsley Publishers, London, 2016. Child Abuse Review 26(2): 159. DOI: 10.1002/car.2461.

Goetzold S. 2017. An Open and Shut Case of Closed Questions: An Exploration of Joint Investigative Interview Training in Scotland. Child Abuse Review 26(2): 116–129. DOI:10.1002/car.2391.

Houghton C. 2015. Young People's Perspectives on Participatory Ethics: Agency, Power and Impact in Domestic Abuse Research and Policy-Making. Child Abuse Review 24(4): 235–248. DOI:10.1002/car.2407.

McElvaney R. 2015. Disclosure of Child Sexual Abuse: Delays, Non-disclosure and Partial Disclosure. What the Research Tells Us and Implications for Practice. Child Abuse Review 24(3): 159–169. DOI:10.1002/car.2280.

McElvaney R, Culhane M. 2017. A Retrospective Analysis of Children's Assessment Reports: What Helps Children Tell? Child Abuse Review 26(2): 103–115. DOI:10.1002/car.2390.

Meredith W. 2017. Book review of Recognition of Child Abuse for the Mandated Reporter by A. P. Giardino, L. Shaw, P. M. Speck and E. R. Giardino, GW Medical Publishing, St Louis, Missouri, 4th Revised Edition, 2015. Child Abuse Review 26(2): 158. DOI: 10.1002/car.2427.

Prevoo MJL, Stoltenborgh M, Alink LRA, Bakermans-Kranenburg MJ, Van IJzendoorn MH. 2017. Methodological Moderators in Prevalence Studies on Child Maltreatment: Review of a Series of Meta-Analyses. Child Abuse Review 26(2): 141–157. DOI:10.1002/car.2433.

Stoltenborgh M, Bakermans-Kranenburg MJ, Alink LRA, Van IJzendoorn MH. 2015. The Prevalence of Child Maltreatment across the Globe: Review of a Series of Meta-Analyses. Child Abuse Review 24(1): 37–50. DOI:10.1002/car.2353.

Walton J, Duff S, Chou S. 2017. A brief discussion about measuring child molester cognition with the Sex With Children Scale. Child Abuse Review 26(2): 91–102. DOI:10.1002/car.2361.

Ward T, Keenan T. 1999. Child molesters' implicit theories. Journal of Interpersonal Violence 14: 821–838.

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http://doi.org/10.1002/car.2439

http://doi.org/10.1002/car.2461

http://doi.org/10.1002/car.2391

http://doi.org/10.1002/car.2407

http://doi.org/10.1002/car.2280

http://doi.org/10.1002/car.2390

http://doi.org/10.1002/car.2427

http://doi.org/10.1002/car.2433

http://doi.org/10.1002/car.2353

http://doi.org/10.1002/car.2361