Mobilizing evidence into tertiary prevention of child sexual abuse: A pilot study

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Project Summary/Abstract Child sexual abuse is one of the most disturbing issues confronting the public health sector. It is estimated that one in four girls and one in eight boys will be sexually abused before reaching the age of 18. Moreover, victims of such abuse are known to experience a wide range of psychiatric, behavioral, and relationship problems over their lifetimes. While much progress has been made in recognizing that child sexual abuse is a major public health problem, there have been few rigorous studies of tertiary prevention interventions designed to minimize re-offending amongst those individuals who have perpetrated child sexual abuse. The only random clinical trial with adult males, who perpetrate the vast majority of sexual abuse, began in 1985 and its final results were published in 2005. This study, funded by the State of California and a state enhancement grant from the National Institute on Mental Health, found no differences between treated and untreated sexual offenders using a first-generation relapse prevention approach, although they found some indications of effectiveness in those who met the treatment program goals. This proposal describes a feasibility and pilot study of a model tertiary prevention program designed to target adult men who have committed child sexual abuse. This model intervention was developed with input from a panel of international experts in sexual offender treatment convened in September 2019 with funding from the Social Science and Humanities Research Council of Canada and the Eunice Shriver National Institute of Child Health and Development. This application proposes a small pilot study with a sample drawn from male inmates incarcerated by the Minnesota Department of Corrections (MnDOC) and within 20-24 months of release from sentences for criminal sexual conduct against victims aged under 14 years of age. Participants will be randomly assigned to either complete the model intervention or receive treatment as usual through MnDOC. Data will be collected on the process of intervention implementation and outcomes of the intervention as measured by participant self-report and reports of disciplinary actions experienced during participants’ incarceration. Data will also be collected on factors that could influence outcome, such as therapist characteristics, participant characteristics, motivation, and participation. Process measures related to intervention completion, barriers encountered, and fidelity to the intervention will be obtained. The purpose of this proposed project is to provide information and data that will allow for the design and development of a multinational, random assignment, long-term effectiveness study. Thus, statistical analysis will explore effect size rather than statistical significance and issues encountered will be documented. This will allow for calculation of necessary sample size and for modification of the intervention and methods for a subsequent study to explore the effectiveness of the model intervention across jurisdictions and cultures.