By Thomas D. Oellerich
ABSTRACT: Child sexual abuse is immoral and should be condemned. However, equally immoral is the activity perpetrated by "child savers." These are professionals who, in their zeal to protect alleged child and adult victims of child sexual abuse, adversely impact the lives of individuals and families. The primary purpose of this paper is to provide a set of indicators which should alert practitioners that they are in the presence of these professionals. A second purpose is to recommend alternative ways for social workers and the profession to deal with child savers.
The recent allegations of sexual abuse in Wenatchee, Washington suggest that the zealotry that marked such cases as the McMartin Preschool in Manhattan Beach, California, the Wee Care Day Care Center in New Jersey, the Little Rascals Day Care Center in North Carolina, and Faith Chapel in San Diego persists. These cases represent a twentieth-century witch hunt. Child sexual abuse is immoral and illegal. Some children need protection. But, as indicated by these and other cases (Nathan & Snedeker, 1995), they and their families need protection as well from present day "child savers" (Wexler, 1995). These are the descendants of the child saving and child rescue movements of the nineteenth and early twentieth centuries (Costin, 1985; Wexler, 1995). They are the professionals-social workers, therapists, physicians, law enforcement personnel, prosecutors-who, in their zeal to protect children, instead harm them and devastate the lives of families (Freyd, et al., 1993; Tavris, 1993; Wexler, 1995; & the newsletters of the FMS Foundation).
The purpose of this paper is twofold: 1) to identify those indicators that should lead one to suspect a professional is a child saver, and, 2) to make recommendations to social work practitioners and the profession to deal with this category of professionals.
The Indicators for Child Savers
A review of the literature suggests that child savers manifest certain beliefs concerning the problem of child sexual abuse. These beliefs, in turn, can serve as indicators for suspecting a professional may be a child saver.
The first indicator that a professional may be a child saver is when he or she becomes a proselytizer. This professional spreads the gospel of satanic ritual abuse, despite the absence of corroborative evidence for such allegations. Lanning (1991) reported that, despite intensive investigations over an eight-year period, law enforcement officials had found no credible evidence supporting allegations of ritual abuse. A five-year governmentally-funded study, conducted by Goodman, Qin, Bottoms, and Shaver (1994), concluded that hard evidence for satanic ritual abuse "was scant to nonexistent" (p. 6). And, more recently, Bottoms and Davis (1997) observed that there never were highly organized satanic ritual abuse cults in this country. They based this conclusion on their own surveys, the fact that the police and FBI agents have never found evidence of satanic ritual abuse, and the discrediting of and the recantations by alleged victims.
But the child savers firmly believe the claims of ritualistic abuse and continue to promulgate this notion (Goodman et al., 1994; Bottoms & Davis, 1997; Bottoms, Shaver, & Goodman, 1996). They reject reports as biased that do not corroborate the existence of satanic ritual abuse. The evidence, however, confirms the conclusion of the San Diego Grand Jury (1992, June), which investigated that county's child protective system and concluded that:
the existence of satanic ritual abuse is a contemporary myth perpetuated by a small number of social workers, therapists, and law enforcement members who ... cannot be dissuaded by a lack of physical evidence (p. 18).
This contemporary myth is far from benign. As Bottoms and Davis (1997) point out, those who become involved with these professionals may live the rest of their lives with a false, painful belief. And they may act on this belief with untold harm to innocent individuals. These are often parents who are subjected to misguided lawsuits and imprisonment for crimes they did not commit.
Second, child savers are those professional interveners who should remain objective but do not. They act as validators (Gardner, 1991). These professionals have as their purpose to "validate" even the most bizarre of allegations. The investigation of the Alicia Wade case by the San Diego Grand Jury (1992, June) revealed that county's child protective system to be inherently biased and unable to detect or correct its errors. In this system, social workers, therapists, investigators, and prosecutors operated on the presumption that an allegation of child sexual abuse meant that the abuse had in fact occurred. Evidence to the contrary was routinely ignored.
Indeed, the Grand Jury (1992, February) reported that some social workers may well have committed perjury in order to gain convictions. Lorandos (1995) also reports social workers withholding or falsifying information in civil proceedings in order to secure a judgment they deemed "in the best interests of the child."
Third, child savers are those professionals who disseminate exaggerated claims of the prevalence of child sexual abuse in this country. For example, they refer to the work of Russell (1983) or Wyatt (1985). Russell reported that more than half (54%) of all women experienced some form of intra- and extrafamilial sexual abuse prior to age 18; Wyatt, that more than three-fifths (62%) of women had. As noted by Okami (1990), these prevalence rates far exceed the rates reported in virtually all other major studies.
These high rates, according to Okami, are the result of using moral and political criteria to define abuse. In this context, Okami points out that Russell's study was severely compromised by her selection and training of her interviewers. Moreover, both studies dismissed self-reports of inconsequential or of loving, noncoercive adult/nonadult sexual interactions as invalid interpretations of their experiences.
In point of fact, the actual prevalence of child sexual abuse is not known. Reports of prevalence from different surveys range from 6% to 62% for females and from 3% to 30% for males (Geffner, 1992; Peters, Wyatt, & Finkelhor, 1986). Such a range of numbers hardly instills confidence about what is really known about the prevalence of child sexual abuse.
Estimates of the prevalence of child sexual abuse are complicated by variations in the definitions of sexual abuse, as Levitt and Pinnell (1995) note in their review of the literature. Definitions vary with respect to the types of behavior that is to be included, the age differences between those involved, and the presence or absence of coercion and/or force (Browne & Finkelhor, 1986). Thus, some studies define sexual abuse as including everything from exhibitionism to rape to incestuous intercourse. Others use more narrow criteria. As a result, Levitt and Pinnell conclude that it is impossible to determine the true prevalence of child sexual abuse.
In a similar fashion, the child savers prefer referring to the numbers of reported cases of child sexual abuse. They ignore the fact that considerably less than half of reported cases are substantiated (Lorandos & Campbell, 1995).
Additionally, child savers claim that the increased rate of reported cases reflects a real increase in prevalence. Thus, they assert there is an epidemic of child sexual abuse (Loftus & Ketcham, 1994). But the evidence does not support this claim. Feldman, et al. (1991) compared data obtained in the 1970s and 1980s with data from the 1940s and found that the prevalence rates were similar. Kilpatrick (1992), in her study of 501 women from Florida and Georgia, found, when her data were analyzed by different age groups, a definite trend toward decreasing sexual activity among those 14 and under over the past 60 years, while the trend for adolescents had remained constant over that same period of time.
The child savers, however, prefer the larger numbers, as these provide them with what Gilbert (1991) refers to as "advocacy numbers" as opposed to legitimate numbers. Advocacy numbers are figures that are used to persuade public opinion that a problem is significantly greater than is generally recognized, rather than attempting to foster scientific understanding.
The Trauma Ideologist
Fourth, child savers are purveyors of what Schultz (1980) refers to as trauma ideology. Trauma ideologists regard every incident of sexual abuse as inevitably psychologically harmful, even devastating (Cole, 1982). That sexual contacts of a minor with an adult might be experienced without harm or even positively, is, to the child savers, heresy. For example, Kilpatrick (1992) concluded that early child and adolescent sexual experiences, unless there was force or high pressure involved, had no influence on later adult functioning regardless of the type of partner involved (i.e., relative or non-relative) or the age differences. She reported that, when she discussed her findings with professionals, they closed their ears to them. They were most closed to those findings that indicated positive reactions to these early sexual experiences and to those findings that indicated that incestuous experiences did not cause irreparable harm (p. xviii).
The evidence suggests that, although child sexual abuse is potentially psychologically damaging, this is not always the case. A review of 45 studies by Kendall-Tackett, Williams, and Finkelhor (1993) concludes that up to 49% of the sexually abused children suffered no psychological harm. Thus, Kendall-Tackett, et al. concluded that a lack of symptoms could not be used to rule out sexual abuse since "there are too many sexually abused children who are apparently asymptomatic" (p. 175).
Among those with psychological harm, Kendall-Tackett, et al. report that some become worse. However, the majority of studies in this review indicated that, when the sexually abused children in treatment were compared with nonabused children in treatment, the sexually abused were less symptomatic than their nonabused clinical counterparts. In addition, the majority of those showing psychological harm improved markedly within 12 to 18 months with or without treatment.
In an earlier review of 28 studies, Browne and Finkelhor (1986) concluded that, when studied as adults, less than 20% of those who had been sexually abused as children had serious psychopathology as adults. Browne and Finkelhor observed that these findings should provide comfort to victims since severe long-term effects were not inevitable. They note with concern the efforts of child advocates to exaggerate the harmful effects for political purposes because of its potential to harm the victims and their families.
That the claims of harm are exaggerated and, indeed, may well be inaccurate is substantiated in a landmark study by Rind and Tromovitch (1997). These researchers noted that most of the prior reviews had drawn upon clinical and legal samples, which are not representative of the general population. They conducted a meta-analysis of seven studies that used national probability samples, which are more appropriate for making population relevant inferences. The studies included four from the United States, and one each from Great Britain, Canada, and Spain. Their findings indicated that harm from child sexual abuse is not pervasive among those who experienced early sexual experiences. Further, the harm, when it occurs, is not serious.
These findings confirm the earlier findings of Kinsey and his associates (1953) who found that, among those participants (24%) who had had sexual contact with adults in their childhood, 80% recalled being emotionally upset by these contacts. However, in all but a few cases, the negative effect was "nearer the level that children will show when they see insects, spiders, or other objects against which they have been adversely conditioned" (p. 121).
Moreover, Rind and Tromovitch's meta-analysis supports the view that the behaviors and attitudes exhibited by the sexually abused are unlikely to be the effects of the sexual abuse. They may be the result, instead, of preexisting problems, or even of professional and community intervention, as earlier reported by Constantine (1981).
Further, there is no sound research supporting the stereotypical linkage of child sexual abuse and later adult psychopathology. Existing research in this regard is so seriously methodologically flawed that it is virtually valueless, according to Pope and Hudson (1995). A similar conclusion was arrived at by staff of the False Memory Foundation (Staff, 1996, September) who, with the help of members of the Foundation's Scientific Advisory Committee, analyzed the research in this area. They identified the assumption that childhood sexual abuse results in the development of psychiatric disorders in adulthood as a leading candidate to join the ranks of other mental health myths. They noted that
to question the pathogenic effects of childhood sexual abuse is often considered heretical-just as it would have been scandalous, a generation ago, to question whether bad mothering could turn children into schizophrenics (p. 3).
It is, in fact, far from proven that childhood sexual abuse has any significant influence upon the adult personality. As noted by Seligman (1994), adults are not prisoners of their past, even a past marked by childhood trauma.
That child sexual abuse may not be harmful is not to condone it or to suggest that it should not be considered either immoral or illegal or both. Conte (1985) has pointed out that decisions concerning the appropriateness of adult/nonadult sexual interactions involve ethical, legal, and religious principles. By way of example, robbery is unlawful not because it results in psychological harm but because society has decided that people have a right to their own property. Put another way, the question of the effects of child sexual abuse should not be confused with the moral and/or legal issue of dealing with this behavior.
The Therapy Marketeer
The final indicator suggesting a professional may be a child saver is when the professional acts as a therapy marketeer, exaggerating the need for therapy for the victims of sexual abuse. From 44% to 73% of victims are likely to receive some form of psychotherapy (Finkelhor & Berliner, 1995; Miller, Cohen, & Wiersema, 1996). This, of course, is in line with a belief in the trauma ideology.
Many children, however, are referred to therapy who do not need to be. The fact that significant numbers of the sexually abused are not psychologically harmed and those who are improve within a year or two without any treatment attests to the minimal need, if any, for therapy. Thus, the concern expressed by the San Diego Grand Jury (1992, February) that referrals to therapists were simply "feeding another subindustry of the System" (p. 37) is well founded. The approach of the psychotherapeutic community to child sexual abuse reflects a mental health industry searching for a new disease which offers it new opportunities for economic growth (Costin, Karger, & Stoesz 1996).
Further, there is no sound research evidence indicating that therapy for the sexually abused is effective (Berliner, 1995; Berliner & Elliott, 1996; Reid, 1996). Holenberg and Ragan (1991) reported in their synthesis of selected research projects funded by the National Center on Child Abuse and Neglect that most of the information on treatment efficacy was based on anecdotal case studies or descriptions of treatment programs.
Most treatment programs are either atheoretical or based on untested theoretical assumptions (Friedrich, 1996). And this is to the everlasting harm of some (Campbell, 1994). For example, in the Alicia Wade case, it was as a result of her therapist's brainwashing in over of year of so-called therapy involving twice weekly visits that Alicia finally "disclosed" that her father had raped her (San Diego Grand Jury, 1992, June 23). In fact, as Alicia had previously maintained, she had been raped by a stranger — and it turned out he was a serial rapist!
Lest this be seen as idiosyncratic, a recently completed evaluation of repressed memory claims with the State of Washington's Crime Victims Compensation Program (Loftus, 1997; Parr, 1996) clearly indicates the potential for the harm that can be inflicted by therapy. Some therapists believe that childhood sexual abuse is a central experience in the lives of their clients (Campbell, 1994). They contend that the trauma of child sexual abuse motivates the patients to repress this experience. Given the centrality of this experience, these therapists assume it is necessary for their patients to recover previously repressed memories of their sexual abuse if they are to heal.
But quite the opposite can occur, as indicated by Parr's (1996) study. She reported that patients involved in repressed memory therapy displayed
an unusually high rate of mental and emotional problems which manifest during therapy and are proliferated as therapy continues. Repressed memory patients tend to be in therapy significantly longer than other mental health clients but with little improvement in their conditions even after years of therapy. Indeed, it appears that the longer the patient is [in] treatment, the more disabled s(he) will become. Of significant concern is that over the course of time, repressed memory patients often become isolated from their families and communities, suffer employment and financial losses and demonstrate devastating mental problems which diminishes their capacity to form or maintain meaningful relationships or enjoy life (Parr, pp. 1-2).
Moreover, anecdotal case studies show that therapists have implanted memories of childhood sexual abuse that never occurred (Loftus & Ketcham, 1994; Ofshe & Watters, 1994; the newsletters of the FMS Foundation).
Additionally, there is growing evidence that the recent epidemic of Multiple Personality Disorder (MPD) is an artifact of therapy. It is a therapist induced disorder rather than an effect of child sexual abuse (McHugh, 1993; Ofshe & Watters, 1994; Sarbin, 1997). Parr (1996) reported that the primary diagnosis in most repressed memory claims to the Crime Victims Compensation Program was MPD and that it was not unusual for the claimant to have dozens or even hundreds of personalities — one claim involved over 700 alter states and another over 3000. Parr's findings buttress the conclusion of Ofshe and Watters:
Examining the fad diagnosis of MPD, the cruelty of recovered memory therapy becomes particularly clear. Thousands of clients have learned to display the often-debilitating symptoms of a disorder that they never had. They become less capable of living normal lives, more dependent on therapy, and inevitably more troubled (p. 223).
Lastly, there is no evidence that reliving the abuse experience has any positive effects. Seligman (1994) notes that, although catharsis has a long history as a therapeutic technique, there is no evidence that it works. He adds that efforts by parents and well-meaning therapists and courts of law often magnify the trauma in the child's mind by repeatedly tearing off the protective scar tissue of the wound. Thus, these well-intentioned people are actually interfering with the natural healing process.
In brief, child savers are those professionals who purport to protect victims of child sexual abuse but who instead harm them and devastate the lives of families. They have certain beliefs which are red flags for identifying them: 1) a proselytizer who spreads the false gospel of satanic ritual abuse; 2) a validator who confirms uncorroborated allegations of sexual abuse no matter how bizarre; 3) an exaggerator or user of advocacy numbers; 4) a trauma ideologist; and 5) a therapy marketeer.
How should social workers and the profession protect the community from the harm caused by child saving and how should these perpetrators be dealt with? Nathan and Snedeker (1995) note that "the demonization of child sexual abuse as society's ultimate evil has rendered it so holy as to be virtually immune to reasoned analysis" (p. 252). It is this atmosphere of hysteria which breeds and sustains the child saver. Social workers and the profession can and must do a number of things to minimize, if not eliminate, this atmosphere of hysteria and mitigate the impact of the child savers. These include:
- Social workers and the profession need to rid themselves of the socio-political and legalistic biases contained in the use of such terms as "victims" and "perpetrators." As recommended by Nelson and Meller (1994), until damage has been established, such terms as "participant" or "partner" would be better to use.
Further, professionals should reserve the use of condemnatory terms to those situations where damage is clearly established. Nelson and Meller recommended that the terms, "molestation" and "rape," should be used only when it has been determined that coercion was indeed present. To define experiences as abusive which are described by the allegedly abused as loving, caring, or noncoercive is a contradiction in terms (Okami, 1994). Hence, the term, "abuse," should be replaced by such terms as "experience" or "incident" until it is determined that the episode was, in fact, harmful.
- Kilpatrick (1992) noted there is an assumption that children who have sexual experiences with or propositions from persons who are 5 or more years older than they, "are automatically victimized, and harm is done" (p. 115). This notion is derived from what Okami (1994) referred to as the sex-political principle. This principle assumes that the differential degrees of social power accorded older persons and younger persons automatically define any sexual contact between such persons as abusive. Kilpatrick's findings repudiate this assumption. She found that the relative age of the woman's partner in her early sexual experience(s) was not related to her adult functioning. Accordingly, practitioners should not assume an abusive situation until it has been established the situation entailed coercion and/or was in fact harmful.
- Social work practitioners and the profession must educate the community and, most especially, the courts about the myths that surround the problem of child sexual abuse. It is these myths that fuel the hysteria surrounding considerations of childhood sexuality (Okami, 1994). First, professionals need to rebut the myth that early sexual experiences are necessarily and inevitably psychologically harmful. It is not the function of professionals or the profession to provide a psychological justification for the fact that such experiences are and/or should be illegal and/or immoral. This is a lesson that mental health professionals should have learned from the controversy over homosexuality.
Next, the profession and professionals must inform the community that therapy is most often unnecessary and is contraindicated in most cases of early sexual experiences. Indeed, professionals must make the community aware that therapy is potentially harmful and that it may well interfere with the natural healing processes. Seligman (1994), in writing of his early experiences with what today would be labeled child sexual abuse, asserted these experiences had no negative impact on his later psychological adjustment. He attributed this to his having been spared the overreaction of parents and police, and early therapeutic intervention to undo his "denial," and later therapeutic intervention to recover his "repressed" memory and then reliving the experience to heal his current problems. Parents and the community should be advised to follow Seligman's recommendation "to turn the volume down as soon as possible" (p. 235).
- Tavris (1993) denounced the "incest-survivor machine" as a multi-million dollar industry built around the concept of child sexual abuse. The average cost associated with repressed memory claims in the state of Washington's Crime Victims Compensation Program was approximately four times the average claim in other mental health claims (Parr, 1996). The average cost of nonrepressed memory claim was less than $3,000; that of repressed memory claims, more than $12,000, with one claim exceeding $50,000. In just over four years, the citizens of Washington paid out over 2.5 million dollars for 325 repressed memory claims. Most of the diagnoses in this program involved MPD.
Parr's study confirms Piper's (1994) contention that psychotherapy for this condition is far from being cost effective. It is, however, highly lucrative for the therapists. In a similar vein, a recent report of the National Institute of Justice found that up to 50% and more of the child sexual abuse victims receive mental health care at an average cost of $5,800 (Miller, et al., 1996). This contrasts with a usage rate of no more than 4% for victims of other crimes with an average cost of less than $100.
Given the absence of sound research evidence demonstrating the efficacy of therapy and its potential for harm, the profession and practitioners should support private health insurance companies and government health care programs to follow the lead of the state of Washington and not reimburse for any treatments deemed experimental, such as those aimed at the recovery of memories of sexual abuse (Staff, 1997 March; 1997 April).
Or, at the very least, as recommended by Parr (1996), treatment should follow managed care restrictions for short-term, limited intervention. Thus, the financial incentives of therapists to operate what Campbell (1994) refers to as "rent-a-friend" agencies with long-term leases will be undermined. These serve the therapists' interests but not those of their clients.
- The profession and practitioners must work toward the passage of informed consent laws in the provision of psychotherapy. Indiana is the first state to pass such legislation (Freyd, 1997, June). Given the harm that can occur as a result of treatment, patients have an ethical right and must have a legal right to be informed of the risks as well as the potential benefits of therapy. The risks include suicidal ideation, self-mutilation, and mental decompensation necessitating inpatient hospitalization (Ofshe & Watters, 1994; Parr, 1996). With this information, prospective patients can make an informed decision as to whether to subject themselves or their children to the risks associated with treatment.
Additionally, the patient's spouse or partner, and other family members need also to be advised of the side effects of therapy. They need to be prepared for the new and often bizarre behavior that the patient may exhibit. They need to know how they are to cope with these changes.
- In light of the harm that can and does occur to patients, social work practitioners must act to support patients in their efforts to sue their therapists. Practitioners need to have available a list of attorneys to whom they can refer their clients to pursue such lawsuits.
Successful lawsuits have been brought against therapists. For example, most recently, Patricia Burgus won an out-of-court settlement of $10.6 million against the Rush-Presbyterian-St. Luke's Hospital, and Drs. Poznanski and Braun for having implanted false memories of sexual abuse (Belluck, 1997). Earlier, the Wade family lawsuit against San Diego County and the professionals who brought about their tragedy was settled for $3.7 (Hagen, 1997). Two former patients of Dr. Diane Humenansky in Minnesota won multimillion dollar judgments against her for implanting false memories of sexual abuse (Staff, 1996, March). A San Diego jury ordered Dr. Virginia Humphrey to pay $1.9 million in a malpractice suit brought by a father on behalf of his minor daughter who had been misdiagnosed as having been sexually abused (Staff, 1996, October). This led the child to bring allegations of sexual abuse against her father. And, also in San Diego, church day care volunteer, Dale Akiki, acquitted of charges of ritual abuse, settled out-of-court for an estimated $800,000 (Nathan & Snedeker, 1995).
- Social workers and the profession must also support efforts to pass legislation to allow lawsuits by third parties. Third parties can suffer considerable psychological harm at the hands of therapists who practice scientifically unproven and dangerous therapy or who negligently administer traditional therapy. Recently, two state appellate courts ruled that therapists owe a duty to the person that their patient falsely accuses of sexual abuse as a result of the therapist's misdiagnosis (Staff, 1998, May).
- The profession should seek passage of legislation to assure that therapists who abuse their clients are subject to criminal prosecution and the same penalties as is any "perpetrator" of abuse.
- The profession should establish as a standard of practice that those who have a history of having been sexually abused should not practice in the area of sexual abuse. As pointed out by Gardner (1991), many professionals are attracted to the field because they themselves were molested. And many then become validators. This was underscored by Kenneth Lanning, the FBI expert, who noted that these professionals often have a hidden agenda, which is to recruit the children they question "to the brotherhood and sisterhood of the sexually abused" (as quoted in Wexler, 1995, p. 157).
- Social workers and the profession must seek the passage of legislation which denies absolute immunity to sexual abuse investigators who conduct an incompetent investigation. Most especially, validators must be denied absolute immunity.
- Those professionals who falsify information or perjure themselves must be subject to criminal prosecution. A first step in this direction was taken in Texas. Here a federal grand jury handed down criminal indictments against two psychiatrists, a psychologist, a social worker, and a hospital administrator for fraud related to the practice of memory techniques (Freyd, 1997, December).
In conclusion, child sexual abuse is both immoral and illegal and should be condemned. But there is another form of abuse-this is the abuse perpetrated by the child savers. This abuse devastates the lives of individuals and families. It too must be condemned.
"The mood and temper of the public in regard to the treatment of crime and criminals is one of the most unfailing tests of a civilization. We must have a desire to rehabilitate into the world of industry, all those who have paid their dues in the hard coinage of punishment." - Winston Churchill (United States Constitution)
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