A general practitioner (GP) friend of mine recently asked for some advice regarding a 13-year-old girl who had come to her asking for post-coital contraception following intercourse with a 17-year-old male she'd met at a party the previous night. My colleague deemed that the girl was competent to understand what she had done and the implications of any choices she made. The young girl was clear that the intercourse was consensual, but that she now regretted it and wanted nothing more to do with the young man. She did not want it to go any further, and would not give his name. Perhaps not an unusual scenario for any GP providing services to teenagers; but this was made more pertinent by the fact that the young girl was a friend of this GP's daughter. It was also made more pertinent to me as I had just read Margaret Melrose's (2013) paper, Twenty-first century party people. This was clearly a vulnerable young girl, whatever her competence. And what about the young man, and the whole party culture of which they were a part. Was this girl being sexually exploited? How best could she and her peers be empowered to make their own choices without putting themselves at risk of harm? And what advice should I give to my friend as a GP trying to work with this young person, respecting her confidentiality and yet at the same time recognising her duty to safeguard? ‘This was clearly a vulnerable young girl, whatever her competence’ Melrose's paper provides a very thought-provoking commentary on the current discourses around sexual exploitation of young people, drawing on questionnaires and interviews with practitioners working with young people in this field. She found that practitioners sometimes ‘struggled to define or understand precisely what sexual exploitation was’, and that, ‘in any one place, there are several forms of sexual exploitation occurring simultaneously and not all of these will involve abuse through prostitution or commercial sexual exploitation’ (p. 161). Melrose paints a far more diverse picture of the nature of sexual exploitation, which does not always sit comfortably with those being exploited seeing themselves as victims, but rather that they may, in some cases, be exercising agency and seeing their engagement in such sexual activity as ‘just having a good time’ (p. 162). This leads Melrose to take a deeper look at some of the cultural assumptions underlying this, including the whole partying culture, the mainstreaming of pornography and what several practitioners described as trading ‘sex for popularity’ (p. 162). ‘Melrose paints a far more diverse picture of the nature of sexual exploitation’ The fact that a young person may exercise some agency in engaging in sexual activity does not mean that they may not also be the victim of sexual exploitation, nor that they are necessarily culpable for any harm they may suffer as a result. This issue of culpability is picked up in our second paper by Tasha Menaker and Audrey Miller (2013). They interviewed 300 undergraduate criminal justice and psychology students using a vignette describing a ‘16-year-old runaway, Leah, who entered prostitution at age 14 and continued to prostitute to earn money for food and shelter and to support a drug habit’ (p. 173). The authors found that those students with stronger sexist attitudes were more likely to attribute blame to the young girl, were less likely to recommend counselling or mental health services, and more likely to recommend incarceration. If, however, the students were told about her background history of victimisation, they were less likely to attribute blame. This study, along with that of Melrose, challenges some of our attitudes and preconceptions towards young people, and should make us question how much, even subconsciously, we perhaps attribute blame to those who are themselves victims. ‘This issue of culpability is picked up in our second paper’ The paper by Susan Alderson and colleagues (2013) also potentially challenges some of our perceptions – this time around men who are perpetrators of domestic violence. Alderson and colleagues point out that ‘there is little empirical evidence to suggest that the legal and policy landscape recognises that perpetrators of such violence are often central in the lives of children as fathers/father figures. Likewise, research shows that violent men often fail to recognise the impact that their partner abuse has on their children’ (p. 183). They analysed data from an online survey and in-depth interviews with men on domestic violence programmes, their partners/ex-partners, programme workers (including women's support workers) and funders/commissioners of those programmes, to explore what positive outcomes of such programmes might look like for children. They argue that success for these programmes should go beyond merely stopping the violence (important as that is) to encompassing a more positive engagement of these fathers/father figures in their children's lives: ‘If men develop a deeper sense of what it is like for children to live under their regime of control, alongside taking responsibility for change, this represents a level of potential change that is more than just stopping using violence; it requires changing how they interact and engage with their children’ (p. 188). Part of this, they argue, is that men should be enabled to talk with their children about their involvement in such programmes and about the steps they are taking to end their abusive behaviour. Without minimising the culpability of perpetrators of all forms of violence, perhaps we can see them also as individuals who, with appropriate help and support, can instead become more positive agents in the lives of their children and partners. However, as Featherstone and Fraser (2012) have pointed out, such work does raise tensions, and there is currently a lack of evidence of the effectiveness of such programmes. Building motivation for change is a key task for interventions with abusive men (Stanley et al., 2012); the research by Alderson et al. demonstrates some ways in which this motivation can be developed. ‘They argue that success for these programmes should go beyond merely stopping the violence’ ‘Building motivation for change is a key task for interventions with abusive men’ Eric Miller (2013) looks at a broader aspect of fathering in his critical review of the father wound concept. While paternal violence is clearly harmful to both partners and children, paternal absence, either physically or emotionally, may be equally damaging in other ways. He argues that traditional concepts of the father role have left many boys growing up with feelings of rejection by their fathers. Miller suggests that ‘the father wound – or behaviours that would lead a male to ultimately feel such a wound – should be viewed as a potential form of psychological abuse’ (p. 197). However, citing the example of Barack Obama, he points out that a father wound does not necessarily have to be a driving force of negativity in a man's life. [Rather, it] ‘can have a positive motivational influence on the lives of men and those around them’ (p. 203). Miller also points out that cultural attitudes towards fathering are changing in favour of more involved, nurturing fathers. We will have to wait to see whether this style of parenting results in a lower prevalence of such a father wound. In an editorial for last year's special issue of Child Abuse Review, Harry Ferguson highlighted Brid Featherstone's important work conceptualising fathers as resources, as vulnerable and as risks (Featherstone, 2009; Ferguson, 2012). Miller's paper highlights different aspects of all three concepts. ‘A father wound does not necessarily have to be a driving force of negativity in a man's life.’ In our final paper, Eija Paavilainen and Aune Flink (2013) describe how they developed national guidelines in Finland to assist nurses in recognising and responding to physical and emotional abuse and neglect. The confidence of nurses in identifying and responding to child abuse and neglect has previously been highlighted (Raman et al., 2012), and may fall behind that of doctors, both in hospital and community settings, so this approach to evidence-based guidance specifically for nurses is particularly welcomed. ‘This approach to evidence-based guidance specifically for nurses is particularly welcomed’ There are three book reviews and a training update in this issue: Jess McCormack (2013) reviews ‘Rosie 2’, a serious training game from the Centre for Child Protection at the University of Kent. This looks like an excellent resource for those who want to take advantage of the opportunities provided by digital media to go beyond simplistic approaches to learning, and really tackle some of the complexities of child protection work. David Saltiel (2013) reviews the third edition of Butler and Hickman's student textbook, Social Work with Children and Families: Getting into Practice; Lawrie Baker (2013) reviews Alexander and Stafford's Protecting Children and Young People: Children and Organised Sport; while Lucie Shuker (2013) reviews Kelly and Bokhari's Safeguarding Children from Abroad: Refugee, Asylum-Seeking and Trafficked Children in the UK. The issues faced by migrant children and young people have been a frequent theme in this journal, particularly picked up in our 2011 special issue on safeguarding refugee and asylum-seeking children (Thomas and Devaney, 2011), and papers last year by Hek et al. (2012) and Westwood (2012). Shuker's review suggests that the book by Kelly and Bokhari should enable readers of the journal to explore these issues further. Shuker finishes her review by commenting that ‘Given the often dualistic representation of separated children as either passive and in need, or an immigration threat (effectively discussed in chapter eight), this book will do much to raise awareness of the complexity of separated children's experiences, and can only improve our safeguarding responses as a result.’ (p. 223) That rounds off this issue, bringing us back to reflect on our own perceptions of individuals, their culpability, vulnerability, agency and potential. Perhaps, rather than simplistically labelling individuals as victims or perpetrators, or as culpable or not-culpable, we can seek the inherent potential within each individual to make positive choices, and consider how best we can enable that potential to be brought out. ‘To reflect on our own perceptions of individuals, their culpability, vulnerability, agency and potential’
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Peter Sidebotham (2013) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: