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Child sex abuse treatedas public health problem

/ Source: The Associated Press

The caller’s voice is tentative, shaky — a little guarded.

Listening to her, Amanda Horowitz can hear children chattering in the background. Maybe, she thinks, they’re the kids this woman is calling about.

“Are you concerned about someone in the children’s life that may be at risk to sexually abuse them?” Horowitz asks the caller.

Then, a pause.

“So, you’ve talked with the children about whether anyone has directly touched their private parts,” she continues.

The caller wants to know if children are likely to say whether they’ve been molested if they’re asked.

“I really wish I had the answer you’re looking for,” Horowitz says, her voice calm and assuring even as her response is bound to disappoint. “But unfortunately what I’m going to tell you is that 88 percent of children never disclose sexual abuse even when they’re directly asked.”

Shifting focus

It’s a typical call for Horowitz, the help line coordinator for Stop It Now!, an advocacy group based in Northampton.

By giving pedophiles and at-risk offenders a phone-in resource center, Stop It Now! is trying to change the public perception and approach to dealing with child sexual abuse. It’s a mission the group has been on since it was started 13 years ago — trying to shift the focus of child sexual abuse from solely a criminal justice matter to a public health problem.

The group’s tactics are gaining a growing audience. Stop It Now! will be part of a child abuse prevention advisory committee being organized by the National Center for Missing & Exploited Children, according to Marsha Gilmer Tullis, director of the Center’s family advocacy division.

'A public health issue'

“Stop It Now! is one of the first programs in the country to really focus on child sexual abuse as a public health issue,” said Jim Mercy, an associate director for science at the Centers for Disease Control and Prevention.

Mercy said child sexual abuse is often the catalyst for such problems as depression, obesity and smoking, which in turn can lead to suicidal behavior, heart disease and cancer among victims, he said.

But rather than reacting to a situation where a child has already been abused, he said, it’s more productive to identify a potential abuser, understand his behavior and get him treatment that may prevent him from hurting a child.

By the end of the call to the help line, the caller waives her guarantee of anonymity so Horowitz can mail her packets of information on how to approach and deal with the person she thinks might be abusing — or is at risk to abuse — the children. Horowitz encourages the woman to call back to do some role playing and talk about specific steps to take.

“She’s struggling with what I think a lot of our callers struggle with, which is having this gut feeling, but it’s about someone they know and care about,” Horowitz said. “They’re thinking: How could this person actually be someone who could do something like this to a child.”

Critics question approach

But critics say questions like that are too overwhelming to handle without notifying the police and questioned a private group’s ability to best deal with an issue like child sexual abuse.

“The response to a report or suspicion of child sexual abuse should involve law enforcement, social services and mental health professionals,” said Northwestern First District Attorney Renee Steese, who has prosecuted child sex abuse cases in Hampshire County, where the Stop It Now! headquarters is located.

“Perpetrators of sexual abuse have tortured, physically assaulted and in some instances murdered their victims,” Steese said. “Short of murder, this is the worst crime that can be committed against a human being. It causes damage to the soul.”

But David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire, finds some benefit to the program.

“There hasn’t been much evaluation research suggesting this tactic works better than anything else to curb child sexual abuse,” Finkelhor said, noting that abusers fall on a wide spectrum ranging from compulsive, repetitive “sex fiends” to people who might molest a child once and become so overwhelmed by guilt that they’ll never do it again.

“But the possibility of deterring those less compulsive offenders is quite good,” he added.

40 percent increase in calls

Joan Tabachnick, the public education director for Stop It Now!, said callers are told to make a police report if they have evidence that a crime has been committed. But “the idea of calling the police when you’re not sure about something like this is unconscionable to many people because they’re afraid of pulling their families or other relationships apart,” she said.

In 2004, the Stop It Now! help line — which is staffed primarily by Horowitz — handled 900 calls from around the country, a 40 percent increase from the year before. Most of the callers were women with a hunch that a child was being abused but no hard evidence of it. A small group of callers — 6 percent — was concerned they may be at risk to abuse a child themselves.

“We want to create an environment where people can talk about these issues and problems without a punitive system clamping down on them,” said Maxine Stein, the chief executive officer of Stop It Now! “That’s not to say people can’t be held accountable. It’s essential that people be held accountable for their actions.”

'We want people to intervene'

Wayne Bowers, a 59-year-old convicted pedophile from Lansing, Mich., said a group like Stop It Now! could have helped prevent him from sexually abusing several boys between the 1960s and the 1980s, when he finally received the therapy he said got him to stop molesting children.

“If there was a Stop It Now!, I would’ve contacted them,” said Bowers, who now runs the Sex Abuse Treatment Alliance, a group based in Lansing that helps reform and counsel sex abusers. “I was concerned about my behavior and I couldn’t find a way to deal with it.”

By making people more aware of child sexual abuse and giving them resources to combat it, Stop It Now! organizers say they’re taking a similar approach that’s worked to curb drunken driving.

“Twenty years ago, it was perfectly normal that before someone graduated high school, they’d know someone who would be killed while driving drunk,” Tabachnick said. “Then Mothers Against Drunk Driving came along and said that’s not acceptable, and the public started shifting the way it thought and acted about drinking and driving.

“We’re trying to do the same thing,” she said. “We want people to intervene before a child is harmed.”