by David Prescott
The following is a preview of what we hope will become a more comprehensive history of our organization. The current version is intended as an overview of interest to members. Many of the original members and others in the field contributed to this article, including Gene Abel, Judith Becker, James Haaven, Jan Hindman, Connie Isaac, Roger Little, Robert Longo, Janice Marques, William Marshall, Vernon Quinsey, and many others.
ATSA's new members quickly find vast resources within the organization's website, list-serve, journal, and newsletter. Pursuing these avenues, however, one quickly discovers the current limitations of both our research and practice. It is difficult to find an article or attend a workshop without encountering the statement "more research is needed".
One can only imagine how Kurt Freund saw the world in the 1940's. Living in Czechoslovakia, Freund helped to develop and research the volumetric penile plethysmograph, a device measuring penile engorgement in response to auditory and/or visual stimuli. The military used his early research to help detect homosexuals joining the ranks. While the plethysmograph has often raised more questions than it answered regarding the nature of sexual arousal and interest, it was the first objective measure of its kind. It provided a common and unified area of study. Freund eventually left Czechoslovakia and settled in Toronto, where his research at Clarke University continued in many fascinating areas. These ranged from the use of plethysmography with sexual abusers to the construct of "courtship disorder".
By the late 1960's in the United States, Dr. Gene Abel became interested in the study of sexuality, and bought a circumferential strain gauge and transducer. He had these connected to an amp-meter, which he would film in the absence of a printout mechanism. A behaviorist by inclination and education, he began to research sexual misconduct. He attended the University of Mississippi, which at the time published a significant amount of the world's behavioral literature. There he met Judith Becker, who was then a psychology intern.
Much of Abel and Becker's initial research examined the use of the vaginal photo-plethysmograph with women as well as the circumferential penile plethysmograph with men. Abel recalls that volumetric plethysmography "never really caught on" in the U.S. Vernon Quinsey notes that the volumetric plethysmograph at that time was more sensitive to movements that can obscure results, was more cumbersome to use, and produced generally similar results to the circumferential plethysmograph. While these may appear as small differences in retrospect, they would become important as the use of the plethysmograph expanded in the 1980's. Abel stresses that at the time, "The driving force was the academics. Others were doing important work, but not reporting it. The objective measurement of the plethysmograph was what brought it all together".
Dr. James Breiling at the National Institute of Mental Health (NIMH) was instrumental in helping get Abel and Becker a grant for the continued study of sexually abusive behavior. In addition to guiding the process, he knew who was involved both in the research and treatment of sexual abusers at a time when no organizations or journals compiled what little was known. As Abel recalls, "Breiling clued us in on what was working in programs".
Many elements combined to make this grant an important turning point in understanding sexual abuse. First, the National Organization of Women had pressed for the establishment of a rape crisis center in Memphis, Tennessee, where the grant activities were first centered. Dr. Abel recalls that Dr. Becker played a vital role in communicating with respect to the agency's concerns for the well being of their clients. Also, money was included in the grant to fund five national conferences, the first of their kind the United States. The first of these was held in Memphis in 1977, while others were set in locations such as Denver, New York City, and Avila Beach, California (near the Atascadero State Hospital). These gatherings were to form the basis for ATSA's annual conferences. Finally, the grant included the development of The TSA News, a newsletter for the "Treatment of Sexual Aggressives".
These elements were designed to promote integration of research and practice as well as contact among those involved in the work. However, only a few people were active in the field at that time. Dr. Breiling recalls, "The first conference was held in Memphis with almost every U.S. program director and researcher present - all could sit around a conference table. For most, this was the first time they had met many of the others". Another aspect of the grant that would benefit ATSA in the future was the support of several post-doctoral students, including William Murphy, who would later become ATSA's president.
A comprehensive history of Abel and Becker's work is beyond the scope of this article. In recounting their work with NIMH, they are quick to note the efforts of numerous individuals at accomplishing the research, conferences, and newsletter. Dr. Breiling adds succinctly, "It was, of course, easy to have these ideas, but the implementation is key, and so the folks who made these conferences realities deserve top billing and credit".
The creation and widespread use of an objective measure and convening of researchers and practitioners created a platform for the activities that would become ATSA. However, Jim Breiling recalls, "When the series of Gene's (Abel) grants ended a decade later, I didn't want the interaction and benefits of the meetings to be lost, but it was a challenge to get the funds required from the program management budget (that part of the NIMH budget that pays salaries, rent, etc.). Meanwhile, in Oregon, Robert Freeman-Longo (now Robert Longo) was aware that the money for these conferences would soon come to an end.
Robert Longo states very clearly that at the start "ATSA was never intended to be an international organization". He and his colleagues had immediate and local concerns around the misuse of the plethysmograph, including its use for determining guilt or innocence, evaluators' lack of experience and training, and in one case, an individual who conducted plethysmograph evaluations of eight hours' duration.
At that time, Longo directed an inpatient corrections program for sexually aggressive adults at Oregon State Hospital's "41B" ward, next to Jim Haaven's "41C" ward, housing developmentally disabled sexual abusers. He recalls that in addition to the potential misuse of assessment methods, inter- and intra-agency difficulties demanded a "consortium" of individuals that could develop standards of practice for evaluating and treating sexual abusers.
In 1982 and 1983, Longo and his colleagues (including Jim Haaven, Ron Wall, and Roger Smith) began to invite professionals from around the state to participate in discussion and training at monthly "brown bag" lunches, separate from the NIMH conferences. Topics ranged from the use of anti-androgen medication and various behavioral techniques to discussion of challenging cases and the use and misuse of the plethysmograph. Jim Haaven recalls, "This was especially important for myself, since we had nothing to go on regarding the use of the PPG with persons with disabilities… Gene Abel and Richard Laws had reservations about its use with this population".
Longo and his colleagues invited professionals from around the state to participate. Among them was Jan Hindman, who had the only plethysmograph lab in eastern Oregon. Besides being ATSA's first female board member and later president, Hindman has vivid memories of the brown baggers' concerns regarding the need for standards of practice at a time when none existed. To this end, she made a 720-mile round trip to attend these monthly meetings. Hindman recounts, "This was also a time in our nation when we were beginning to realize the tremendous problem of sexual abuse that had, for decades, been kept secret". Recalling instances of professionals using the plethysmograph to conclude guilt or innocence in courts, she remembers, "All of a sudden the problem had arrived and plethysmographs started to appear all over the Northwest… after the well-established and ethical effort at the 41-B program came competition and conflict as some others, without training, without scruples, purchased plethysmographs and jumped on the 'band wagon'".
As the brown bag meetings continued, it became more apparent to those involved that the increased public concern around sexual abuse and subsequent proliferation of professionals entering the field made the development of standards of ethical practice necessary. In the fall of 1984, at Longo's invitation, William Farrell (maker of the Farrell Instruments penile plethysmograph) gave a free workshop at Oregon State Hospital. Professionals from around the Northwest and nearby Canada were in attendance, and issues around the plethysmograph's use, calibration, and stimulus materials were discussed. The idea of developing an organization that could unite professionals and develop standards of ethical practice was subsequently promoted and by the end of the year the organization was named The Association for the Behavioral Treatment of Sexual Aggressives.
Robert Longo served as ABTSA's first president, and would eventually receive ATSA's Founder's Award in 1991. Still a very small organization, the original financial records were kept in a shoebox, and Jan Hindman recalls dictating the meetings' minutes on her long drive home. ABTSA's first Board of Directors included Longo as President, Ron Wall as Vice President, Steven Mussack as Secretary, Roger Smith as Treasurer, James Ellis, Randall Green (who also directed a sexual offender unit at Oregon State Hospital), Jan Hindman, Barry Maletzky, Barbara Mallas, and Kevin McGovern.
1984 also saw the establishment of the organization's newsletter, the ABTSA Professional Forum. It was originally typed, edited, printed, published and mailed to the membership by Steven Mussack using a dot matrix printer. Subsequent editors included Gary Horton, Theo Seghorn, and Michael Miner.
By December of 1985, ABTSA had filed its corporate papers. Regular board meetings resulted in the development of committees to discuss membership, bylaws, education, a code of ethics and conduct, and standards for physiological assessment. In April, 1986, the name was changed to the Association for the Behavioral Treatment of Sexual Abusers. Also of note, Ron Wall began to teach a course on the assessment and treatment of sex offenders at Portland State University. As the statewide ABTSA began to attract more professionals, interest in membership grew from areas outside the state. Longo recalls, "We had to make a lot of decisions. We knew if we let this one state in, we'd also have to let that other state in". With the inclusion of other states, ABTSA's growth was swift.
The last of the NIMH-funded conferences occurred in Tampa, Florida in February, 1986, and occurred as a part of a grant awarded to Richard Laws. Hindman recalls meeting at the home of newly-appointed board member Steven Jensen as Robert Longo suggested that ABTSA continue the conference series in Oregon in 1987, "What an idea! We decided to try it in Newport, Oregon, send out a few flyers, hope that maybe some folks would come, especially the folks who had kept the NIMH trainings going in the past. We simply wanted the information, and we hoped that by having a 'kind of conference' we could continue the learning and training needed to have a responsible approach to treating the problem of sexual abuse". Longo recalls that many of the presenters were so supportive of the emerging organization that they refused to be paid for speaking.
Following the successful Newport conference, plans were made to co-sponsor the next year's conference with Gene Abel in Atlanta. Many humorous stories illustrate the difficulties involved in developing an organization and organizing conferences. The original hotel booked for the conference was unavailable due to incomplete construction. ATSA was rebooked into the prestigious Ritz Carlton. Janice Marques recalls "dress codes, limos and chandeliers in the elevators for a bunch of offender researchers and therapists! I remember Rob Longo and I getting turned away from lunch at the hotel because Rob was wearing Birkenstocks". Jan Hindman recalls organizers "trying to look cool" as they brought beer and wine into the hospitality suite.
These growing pains of a developing organization belie the intensity and caliber of the conference and its participants. Presenters included Abel, Breiling, Laws, Marques, Ron Langevin, Mark Weinrott, Barbara Schwartz, Maureen Saylor, Robert Card, William Farrell, Barry Maletzky, Margretta Dwyer, Carol Ball, and others. Hindman estimates that about 100 people attended, the majority from the Northwestern US.
The growth in interest brought growth in both research and treatment innovation. The word "Behavioral" was dropped from ATSA's name, reflecting the broadening scope of inquiry. Connie Isaac became the executive director in November of 1993 and developed the organization's conferences into the richer and more polished experiences they are today. Other advances have included the awarding of research grants, the development of state chapters, policy statements and contacts, and, most recently, the Collaborative Outcome Project, investigating treatment efficacy.
Many of the concerns that sparked ATSA's beginnings continue to exist. For example, the proper integration of research and practice continues to be the subject of debate. While few question the need for standards of care to guide ethical practice, disagreement among individuals continues as to how these should be carried out. Many have observed that understanding the organization's history is vital to building its future. Jim Haaven sums up the recollections of most that "It was a group of people with a common interest and need to learn more about sex offending issues, realizing we knew little to nothing, willing and able to be curious, collaborative, and inclusive of ideas and opinions". Roger Little, reflecting on the first of the brown bag luncheons, recalls, "I might add, almost everything we thought we knew at that meeting has proved to be not true".
While ATSA will clearly continue to address the concerns inherent in our work, Jim Haaven speaks for many, "At every ATSA conference I have taken a few minutes to go to the main ballroom before the conference starts and gaze at the sea of empty seats. I am emotionally moved by what we have become and the journey we have made. I take great pride in being a member of this association. Hopefully, we can continue to remember what made us what we are. This spirit is most clearly seen when new chapters develop and the excitement of discovery, humility, and camaraderie are reborn".
In compiling this history, I have come into contact with many fascinating people and many interesting (often humorous) stories. I expected disparity between their accounts, but found none. I braced myself to encounter arrogance, but found none. Without exception, everyone I interviewed shared a common sense of intense purpose, a strong desire for continued innovation, and a belief that despite their best efforts, much more work is needed into the understanding and reduction of sexual abuse. I am indebted to them for their persistence, and hope that I have conveyed their courageous determination.
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