I conduct research on clergy pedophilia in the Catholic Church. It is quite protracted over decades, and the massive cover-ups continue to this day. In the Altoona-Johnston Diocese, PA 52 of 56 perpetrators are clergy. Only 1 has been tried and convicted? Two committed suicide as charges were being brought against them. The Diocese is now under federal investigation.

I provide free clinical consultation to survivors. Here are 2 of my published articles on this topic.

Rich

-Surprisingly difficult to finding currently ongoing studies.

Most sources appear in agreement that sexual violence perpetration behaviour is resistant to change.

Also surprising: cultural factors (other than religion) are rarely mentioned.

Sexual addiction treatment stopped being funded after being deleted from the DSM.Aggress Violent Behav. Author manuscript; available in PMC 2018 Mar 29.Published in final edited form as:Aggress Violent Behav. 2014 July-August; 19(4): 346–362.doi: 10.1016/j.avb.2014.05.004PMCID: PMC5875446NIHMSID: NIHMS951565PMID: 29606897

A systematic review of primary prevention strategies for sexual violence perpetration☆

Sarah DeGue,* Linda Anne Valle, Melissa K. Holt,1 Greta M. Massetti,1 Jennifer L. Matjasko,1 and Andra Teten Tharp1Author information Copyright and License information DisclaimerSee other articles in PMC that cite the published article.

Abstract

This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).

Keywords: Sexual violence, Rape, Perpetration, Primary prevention, Effectiveness evaluationGo to:

1. Introduction

Sexual violence2 is a significant public health problem affecting millions of individuals in the United States and around the world (Black et al., 2011; Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002; World Health Organization/London School of Hygiene & Tropical Medicine, 2010). Efforts to prevent sexual violence before it occurs (i.e., primary prevention) are increasingly recognized as a critical and necessary complement to strategies aimed at preventing re-victimization or recidivism and ameliorating the adverse effects of sexual violence on victims (e.g., Black et al., 2011; Centers for Disease Control & Prevention, 2004; DeGue, Simon, et al., 2012; Krug et al., 2002). Successful primary prevention efforts, however, require an understanding of what works to prevent sexual violence and implementing effective strategies. Currently, there are no comprehensive, systematic reviews of evaluation research on primary prevention strategies for sexual violence perpetration. Such a review is needed to inform prevention practice and guide additional research to build the evidence base. To address this gap, the current paper provides a systematic review and summary of the existing literature and identifies gaps and future directions for research and practice in the prevention of sexual violence perpetration.

Primary prevention strategies, as defined here, include universal interventions directed at the general population as well as selected interventions aimed at those who may be at increased risk for sexual violence perpetration (Centers for Disease Control & Prevention, 2004). To capture the breadth of possible sexual violence prevention efforts, we defined primary prevention strategies to include any primary prevention efforts, including policies and programs (similar to Saul, Wandersman, et al., 2008). Consistent with the public health approach to sexual violence prevention (Cox, Ortega, Cook-Craig, & Conway, 2010; DeGue, Simon, et al., 2012; McMahon, 2000), strategies to prevent violence perpetration, rather than victimization, are the focus of this review. Although risk reduction approaches that aim to prevent victimization can be important and valuable pieces of the prevention puzzle3, a decrease in the number of actual and potential perpetrators in the population is necessary to achieve measurable reductions in the prevalence of sexual violence (DeGue, Simon, et al., 2012).

1.1. Goals of the current review

1.1.1. Describing the state of the field in sexual violence prevention

The first goal of this review is to describe the broad field of sexual violence prevention research and identify patterns of results associated with evaluation methodology or programmatic elements. Although a number of qualitative reviews, meta-analyses, and one meta-review (e.g., Anderson & Whiston, 2005; Breitenbecher, 2000; Carmody & Carrington, 2000; Vladutiu, Martin, & Macy, 2011) have been conducted over the past two decades, no reviews examine methodological and programmatic elements and sexual violence outcomes across the broad spectrum of sexual violence primary prevention efforts. Several existing reviews focus solely on describing approaches being implemented in the field and the use of underlying theory (Carmody & Carrington, 2000; Fischhoff, Furby, & Morgan, 1987; Paul & Gray, 2011). Two non-systematic reviews identified methodological and programmatic issues associated with sexual violence prevention efforts with college students (Breitenbecher, 2000; Schewe & O’Donohue, 1993) and called attention to the need to measure behavioral outcomes (in addition to changes in attitudes and behavioral intentions) to demonstrate an impact on sexual violence. These reviews also pointed out that the small statistically significant effects reported on the, primarily attitudinal, measures in existing studies may not be truly meaningful (i.e., clinically significant). These existing reviews focused solely on college-based strategies, limiting the generalizability of these findings to community-based and younger audiences.

Three meta-analyses examined the effectiveness of educational prevention programming with college students (Anderson & Whiston, 2005; Brecklin & Forde, 2001; Flores & Hartlaub, 1998), but two of these focused only on attitudinal outcomes (i.e., Brecklin & Forde, 2001; Flores & Hartlaub, 1998). All three reported small to moderate mean effects on attitudes ranging from 0.06 to 0.35 (e.g., rape myth acceptance) and noted that the magnitude of effects decreased as the interval between strategy implementation and data collection increased. In addition, Anderson and Whiston (2005) reported a moderate mean effect size for knowledge (0.57), but reported small mean effect sizes for behavioral intentions (0.14), incidence of sexual violence (0.12), and attitudes considered more distal to sexual violence (0.10; e.g., adversarial sexual beliefs, hostile attitudes toward women), suggesting that the changes may have little clinical significance. Mean effect sizes for rape empathy and indicators of greater rape awareness (e.g., willingness to volunteer at rape crisis centers) were not significantly different from zero. The results from these meta-analyses suggest that knowledge and attitudes are assessed most frequently in prevention programming with college students, with attitudinal measures showing the largest effect sizes in evaluations of those programs. Although attitudes and behaviors are related, attitudes typically account for a relatively small proportion of the variance in behavior (e.g., Glasman & Albarracín, 2006; Kraus, 1995), suggesting that achieving attitude change may not be enough to impact sexual violence behaviors.

The one meta-review (Vladutiu et al., 2011) also focused on reviews of college-based programs. Vladutiu and colleagues noted that reviews often made inconsistent recommendations, primarily due to differences in program context and content and the outcomes examined in the studies. For example, Vladutiu et al. (2011) concluded that longer programs were generally associated with greater effectiveness, but some shorter programs were able to document change when rape myth acceptance was the only outcome of interest. Single-gender audience approaches were generally considered more effective, but primarily when the program focused on attitudes, empathy, and knowledge outcomes related to sexual violence. The meta-review also identified a wide range of content and delivery components that were associated with changes on different outcomes. Finally, Vladutiu et al. (2011) noted that of the reviews included in their meta-review, only one had been published in the last decade (i.e., Anderson & Whiston, 2005). As indicated previously, there are no comprehensive reviews of the sexual violence prevention evaluation literature, and the only systematic reviews have dealt solely with college-based strategies. Relatively few patterns have been identified or recommendations made with respect to improving primary prevention of sexual violence or the rigor of evaluations conducted in the field. An updated, systematic, and comprehensive review of the literature on sexual violence primary prevention programs is warranted.

1.1.2. Summarizing “what works” in sexual violence prevention

The second goal of this review is to identify and summarize the best available evidence on specific sexual violence primary prevention strategies. Prevention practitioners are increasingly being asked to select and implement evidence-based practices and to devote resources toward strategies most likely to have an impact on health outcomes, but guidance and information on navigating this process are lacking (Saul, Duffy, et al., 2008; Tseng, 2012). In particular, we wish to identify effective strategies for preventing sexual violence perpetration behaviors, as that is the ultimate goal of sexual violence prevention efforts. Although targeting risk and protective factors such as attitudes and knowledge are common prevention approaches, the most critical objective is to prevent sexual violence perpetration behaviors and their adverse effects (Centers for Disease Control & Prevention, 2004; World Health Organization/London School of Hygiene & Tropical Medicine, 2010). Evidence regarding change in sexual violence perpetration behavior, however, is generally absent from the literature (Schewe & O’Donohue, 1993; Vladutiu et al., 2011; World Health Organization/London School of Hygiene & Tropical Medicine, 2010). By summarizing the evidence on strategies that have been rigorously evaluated for sexually violent behavior, we can identify and categorize programs that currently appear to have evidence of effectiveness, those that are ineffective, and others that are potentially harmful strategies to assist practitioner efforts at better selecting and implementing sexual violence prevention strategies.

At: NCJRS.gov (National Criminal Justice Reference Service)

Special Feature: Sex Offenders - Treatment and Recidivism

Publications & Multimedia

The Assessment of Risk for Sexual Reoffense in Juveniles Who Commit Sexual OffensesOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015The Effectiveness of Treatment for Adult Sexual OffendersOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015The Effectiveness of Treatment for Juveniles Who Sexually OffendOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015Recidivism of Juveniles Who Commit Sexual OffensesOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015Recidivism of Adult Sexual OffendersOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015Sex Offender Risk AssessmentOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, July 2015Resource Package for Paroling Authorities on Sex OffendersBureau of Justice Assistance-Sponsored, October 2014Sex Offender Management Assessment and Planning InitiativeOffice of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking-Sponsored, October 2014Evaluability Assessments of the Circles of Support and Accountability (COSA) Model, Cross-Site ReportNational Institute of Justice-Sponsored, July 2013Sex Offender ProgramsFederal Bureau of Prisons, February 2013Multi-State Recidivism Study Using Static-99R and Static-2002 Risk Scores and Tier Guidelines From the Adam Walsh ActNational Institute of Justice-Sponsored, October 2012Polygraph Testing for Juveniles in Treatment for Sexual Behavior Problems: An Exploratory StudyOffice of Juvenile Justice and Delinquency Prevention-Sponsored, 2012A Model of Static and Dynamic Sex Offender Risk AssessmentNational Institute of Justice-Sponsored, October 2011Sex Offenders: Recidivism and Collateral ConsequencesNational Institute of Justice-Sponsored, September 2011Sex Offender Management, Treatment, and Civil Commitment: An Evidence Based Analysis Aimed at Reducing Sexual ViolenceNational Institute of Justice-Sponsored, January 2011