Angst and turmoil within the ranks of the Association for the Treatment of Sexual Abusers (ATSA) has been brought to Heretic TOC’s notice this week thanks to a leak from internal discussions.

I did not personally encounter the Deep Throat of this episode in a dimly lit underground car park and do not know his identity (or hers); but the information is highly credible and was transmitted to me indirectly by a source I will be happy to credit later for this scoop, providing no one is going to be compromised.

The leak, from a thread on the ATSA listserve, sees David Prescott, a former president of the association, debating a couple of weeks ago with Steven Sawyer, a psychotherapist in private practice, and Jon Brandt, director of a home for teenage boys on probation.

Prescott had pointed out that there is an ongoing class-action lawsuit regarding Minnesota’s civil commitment program for sexual offenders (MSOP), contesting whether the program is constitutional. He noted that the main local newspaper, the Minneapolis Star Tribune, had described the current state of affairs as an injustice.

Prescott’s view, which did not surprise me as I know him from Sexnet, was broadly liberal. Having himself worked briefly in the Minnesota program, as he declared in this listserve exchange, he had come to accept that even if it might be possible to justify civil commitment for some offenders, Minnesota’s record was highly dubious. The program had been in existence for 20 years. Prisoners were supposed to be released after successful treatment, but after all those years, and with over 700 prisoners going through the program, only one person had ever been released for a significant length of time.

He asked:

“Where do our ethical and moral obligations begin and end? Given the prime directive of the helping professions, ‘First, do no harm,’ this seems a worthwhile question. Much of the media accounts have focused on the appalling lack of courage and fortitude of state lawmakers and officials in addressing MSOP and its legal context. In fact, this has been going on years.

“How long does one have to work in a dysfunctional system before one becomes a de facto collaborator with it? … At what point are we causing harm to our clients through our involvement? Many of us have heard clients say, ‘If you really want to help me, Doc, get me out of here.’ How many have to say this before they have a compelling point?”

Sawyer’s response was defensive, along the lines “We’re not to blame, it’s the courts.” He said they were the ones making the decision to impose civil commitment on an offender, and also when to release that person. The clinicians just provide treatment. So he thought criticising them was “a bit harsh and unfair to well intentioned, professional, and talented people”. They could not be held responsible for what was outside their control.

Prescott took him to task for passing the buck, saying it is “an abdication of our professional responsibilities” just to blame the system.

Brandt agreed, pointing out that earlier this year a federal judge had declared MSOP to be a “clearly broken” system. Brandt went further, too, saying civil commitment in general was an ethical minefield for every professional who is party to it, and indeed all therapy with incarcerated offenders, whether in civil commitment or serving an ordinary prison sentence, involved an ethically problematic “dual relationship”. He was referring to the conflict of roles inherent in trying to serve the client and the state simultaneously. Increasingly, he said, therapists appeared to be less committed to helping the client’s rehabilitation through psychological work and more concerned with security and containment, in response to political pressures.

He spoke of a “treatment paradox”, a sort of no-win situation, or Catch 22: “…in order to successfully complete sex-specific treatment, clients are required to disclose all the details of their sexual history, offenses, and fantasies; often…under the duress of compulsory polygraphs. The dilemma is that the more details that clients reveal, the more they tend to disclose possible risk factors and reinforce the grounds for their own confinement.” Thus clients who cooperate with the system are damned along with those who do not.

In making these points, Brandt quoted from the academic literature in the field, specifically a recent paper by Theresa Gannon and Tony Ward. The good news here is that papers criticising the system are indeed being published, and these critiques are clearly being discussed by such leading figures in the profession as David Prescott. Even Steven Sawyer, defending his colleagues, made no attempt to defend injustices perpetrated from above, by the courts and politicians.

Another good sign recently is to be seen in a new ATSA position paper on its website opposing the horrors of residency restrictions for sex offenders. We have all heard about these oppressive rules, especially in the US, where sex offenders can find themselves living under road bridges because all the local housing is deemed too close to a school, and thus – so it is claimed – presenting a danger to the kids who go there.

Nor was ATSA’s opposition to these unjust rules hidden under a bushel. Not many people will read their website, but the association has also been trumpeting its thinking to the media.

The New York Times had reported last month that “Dozens of sex offenders who have satisfied their sentences in New York State are being held in prison beyond their release dates because of a new interpretation of a state law that governs where they can live.” Since 2005, sex offenders in the state cannot live within 1,000 feet of a school, and a February ruling from the state’s Department of Corrections and Community Supervision extended that restriction to homeless shelters. As the onus is on sex offenders to find approved housing before they are released, the prisons have been keeping them locked up when they have been unable to do so.

ATSA head Maia Christopher leapt into the fray. She sent her organization’s policy paper to New York magazine online (not to be confused with New York Times Magazine but the NYT was doubtless sent a copy too) even before it was up on ATSA’s website. And the message could not have been more clear and robust: the association “does not support the use of residence restrictions as a feasible strategy for sex offender management” because of a lack of evidence they do any good.

Rather than increasing public safety, registry restrictions tended to decrease it, because the “unintended consequences of residence restrictions include transience, homelessness, instability, and other obstacles to community re-entry.” Since “unemployment, unstable housing, and lack of support are associated with increased criminal recidivism,” and housing restrictions lead to all three, they are a bad idea, ATSA argues.

Now, I am sure there will be some heretics here who will be reading all this with a growing sense of incredulity. How can ATSA, the dark force for decades behind regimes of coercive, confrontational cognitive behavioural therapy (CBT), suddenly emerge as radical agents of humane and enlightened policies? Does Not Compute!

Well, all you sceptics, you are not alone in going through a confusing dose of Cognitive Dissonance on this, with new facts bashing up against old experience. I feel it myself, even though another of those new facts is ATSA’s openness to at least be thinking about radical non-CBT therapy – as evidenced by its acceptance of my own recent article proposing a deeper and more humane approach. A corrective against being over-optimistically carried away has been fightback385’s comments in response to Why I am talking to the terrorists.

“Fightback” has usefully pointed out that “ATSA is still ignorant of the research on child sexuality (e.g., Floyd Martinson) and refers to children who behave sexually with each other in developmentally appropriate ways that scare Americans as ‘children with sexual behavior problems’ (CSBP), advocating the use of drastic treatments that teach them their sexual feelings (and by implication, they themselves) are wrong and dangerous.”

In further comments that I would urge everyone to read, Fightback sets out a very persuasive parallel between sex offender therapy and religious authoritarianism. The really important point underlying his thesis, I suggest, is that this authoritarian thinking has not suddenly disappeared. Especially in the US, religion is still very strong. Authoritarian politicians often invoke religious rhetoric in their thunderous denunciations of “evil doers”; and it may be that in ATSA’s other stronghold countries its members include a substantial proportion of those for whom zeal against sex “offending”, even when non-violent, non-coercive and utterly harmless, has become a secular substitute for religion.

These authoritarians have a mindset in which evidence-based policy does not figure strongly: they are content to enforce their received ideas with unquestioning vigour. Their conservative morality is accordingly unlikely to be greatly influenced by progressive forces within their own ranks: even ATSA leaders as senior as David Prescott and Maia Christopher, and researchers as prestigious as Theresa Gannon and Tony Ward, are unlikely to trump the “prophets of old” in their minds, such as Gene Abel, who pioneered CBT. And for the true believers among them, of course, there is no trumping God Himself!

Bearing in mind the continuing existence of this conservative rank-and-file, can ATSA ever be expected to make substantial progress? Even more importantly, can it contribute to changing not just itself and its therapeutic practices but also wider society?

Jesse Singal, author of the New York magazine report cited above, felt that even the relatively modest change involved in getting rid of residency restrictions was no more than a pipe dream. After all, he said, what politician wants to stand up and say, “You know what? I think sex offenders should be able to live closer to children”?

His scepticism makes sense except for the fact that civil society is not led by politicians alone; indeed they tend to follow opinion rather than lead it in our age of opinion polls and focus groups. Leadership these days has passed in many cases to the judges, especially in Europe, where human rights law has racked up many major achievements over the last several decades, including the ending of the death penalty across the continent. The US, too, has enjoyed its great moments of judicial leadership, not least in terms of its increasingly radical interpretation in the 20th century of the First Amendment: it was not the early politicians, the Founding Fathers, but Supreme Court judges such as Oliver Wendell Holmes and Louis Brandeis who most advanced freedom of expression as a vital civil liberty, less than a century ago.

The Supreme Court itself, as opposed to the influential minority opinions of its best judges, has by contrast often been disappointing, not least in terms of rejecting challenges to civil commitment. But that may not last. Crime in general has been falling rapidly in the US for years now, including sex offences against children. Despite all the hype over internet grooming and pornography, the worst of the panic there may be passing (unlike in the UK where historic celebrity and street grooming scandals continue to fuel the flames). Whereas almost the entire civic establishment would once have backed harsher penalties for sex offenders in the US, there is now a growing realisation – including within the judiciary – that unthinking harshness has gone too far. In these circumstances, a reform-minded ATSA may be surprised to find itself pushing against an open door where the judiciary is concerned. The class-action lawsuit against Minnesota’s civil commitment program may not be the hopeless cause that some might suppose.

Heretic TOC hopes that ATSA will accordingly find ways to give this lawsuit their energetic support, whether through the media or within the courtroom or both.