Mental health articles

the paradigm for the prevention of child sexual abuse Programs that target the male sex role and the reduction of offending behavior require a very different paradigm than the current prevention model of introducing occasional programs to children in which they are taught skills to deflect the approaches of offenders. Instead, a proposed paradigm that targets males as potential offenders is suggested. While there are various facets to this proposed paradigm, the one that is discussed here is the school-based component that infuses content throughout the curriculum and across age groups. (See Bolen, in press, for an expanded discussion of this proposed paradigm.) The content of this curriculum focuses on teaching healthy relationship behaviors to children and adolescents. The remainder of this chapter considers how the proposed prevention paradigm differs from the existing one, while offering far greater potential for reducing the prevalence of child sexual abuse. To develop this section, the existing paradigm for the prevention of child sexual abuse is compared to the proposed paradigm along four domains—basic assumptions, orientation, methods, and outcomes. Assumptions: The current paradigm for the prevention of child sexual abuse targets children and teaches them methods for deflecting approaches of potential offenders. The goal of these programs is to prevent abuse by relatives, known others, and strangers by reducing the “vulnerability of children to abuse and exploitation” (Kohl, 1993, p. 139). Thus, these programs: (a) teach children the concept of sexual abuse, often described as bad touching in private places; (b) teach children that they can refuse such overtures and get away from the potential offender; and (c) encourage children to tell an adult about overtures that occur (Finkelhor & Strapko, 1992). At its core, then, the current prevention paradigm has a dire and hopeless assumption—because we cannot effectively target potential offenders, we must target potential victims. Thus, the best we can do is to thwart the attacks of offenders. This strategy is analogous to teaching self-defense strategies to all persons in the United States as the primary prevention strategy for lowering overall levels of violence. The primary assumption of the proposed paradigm is that the problem behavior—the abuse itself—can be dramatically reduced. This more optimistic assumption provides hope for reducing the prevalence of child sexual abuse. Orientation: Another important difference in these two paradigms is their general orientation. For the existing paradigm, the orientation is one of prevention. For the proposed paradigm, the orientation is one of promotion. Much like the Healthy Start program in Hawaii (Mansfield, 1997), this paradigm shift assumes that promoting healthy behaviors is an even better method for reducing problems. In this particular case, the problem behavior is the offending behavior itself. This orientation, then, assumes that male children can be presented alternative and more prosocial definitions of masculinity that allow them to express their masculinity in healthier ways than by choosing aggressive sexuality. Method: The current method of prevention primarily targets young children, teaching them messages of empowerment and methods to thwart potential offenders. These specialized programs, presented to children on an occasional basis, do not consider differential abuse patterns over time and are typically not offered to preadolescents or adolescents. The proposed paradigm, by addressing abuse through the promotion of healthy behaviors, instead infuses content throughout the school curriculum across age groups. Social learning theory suggests that those messages that are most likely to be internalized are those heard consistently over time. Thus, all classes could have some content that models and rewards prosocial behaviors. Further, health or similar classes could have consistent time devoted to this material. While these messages of prosocial behavior should be interwoven throughout the curriculum, there are probably windows of particularly effective opportunity, including preschool and early adolescence. A developmental task of the preschool period is to come to some understanding of gender identity (Schuster & Ashburn, 1992). A developmental task of adolescence is to experience one’s own sexuality and contemplate how to express it. As windows of opportunity, special courses or course content could be developed to target these developmental periods. The focus of this program must also change over time. One of the pertinent findings from the author’s (2000a) secondary analysis of Russell’s (1983) community prevalence survey was that patterns of risk of abuse changed over the lifespan of the child. Approximately half of all abuse committed by juvenile offenders (i.e., under the age of 21) was perpetrated against a friend or date.13 Another 30% of all abuse was perpetrated against an acquaintance. While most friend abuse was committed by offenders under the age of 14, most date abuse was committed by offenders between 14 and 21 years of age. These findings suggest that the program for younger age groups needs to focus on the promotion of healthy behaviors in friendship relations. For middle school and high school populations, however, the focus must include romantic relationships. For all ages, males must be taught better methods of expressing their masculinity than appropriating acquaintances for their sport or conquest. Further, adolescents must learn that sexual activity with younger children—indeed, any child at a younger developmental stage—is never appropriate and is instead harmful. These messages combat those societal messages that encourage males to have sex with younger, less experienced females. Because most abuse is heterosexual, these programs should be especially sensitive to this type of abuse. Yet some abuse is not heterosexual. Some males abuse male children. Further, a few females also abuse male or female children. It is important that these populations are not overlooked. Therefore, broader messages that teach the bounds of appropriate contact in same-sex friendships or romantic relationships, as well as messages concerning the bounds of appropriate contact for younger children, are also necessary. Finally, even though this paradigm directly focuses on healthy relationship patterns that are taught through a guided curriculum, the promotion of healthy relationships can also be interwoven throughout the policies and philosophy of schools. Goals: Outcomes for existing child sexual abuse prevention programs have been measured primarily by the retention of information by participants. The shortterm goal for these prevention programs is that some children are able to thwart the attacks of offenders by using the information they are taught. The short-term goal for the proposed paradigm is two-fold. The first short-term goal is that male children and adolescents exposed to this curriculum will internalize a healthier and more prosocial model of expressing their masculinity. The second short-term goal is that these same male children and adolescents will perpetrate less abuse. Of course, sexually aggressive females should also benefit from this curriculum. The long-term goal for the proposed paradigm is that these young males will also perpetrate less abuse as they come into their manhood. Thus, a realistic goal of this paradigm is that the prevalence of offending behavior can be reduced over time. In summary, it is argued that the only effective method of reducing the prevalence of child sexual abuse is to target potential offending behaviors. To do so, a very differenttparadigm is needed. This paradigm targets one of the most critical causal roles in child sexual abuse—the societal definition of the male role—by promoting healthy relationship patterns. Framing the program in this manner moves the focus and rubric of the program away from methods of extinguishing negative behaviors—a deficit model and one that might be experienced by males as demoralizing—to that of promoting healthy behaviors, a strengths perspective. Further, the focus changes from prevention to promotion. Programs for the promotion of healthy relationship patterns might be successful for the same reason that current prevention programs do not appear to be successful at reducing the prevalence of abuse. They target the reduction of offending behavior rather than the reduction of victimization. Further, they target what many experts consider to be one of the primary causal factors for the epidemic of child sexual abuse and the preponderance of male offenders—the social definition of the male sex role. Targeting one of the important causes of child sexual abuse while providing healthy alternatives for behavior has the potential to finally reduce the intolerable tragedy of child sexual abuse.

Tags: child, sexual abuse