Lessons Learned: Conducting Research With Victims Portrayed in Sexual Abuse Images and Their Parents

Abstract

Victims portrayed in sexual abuse images may be resistant to participate in research because of embarrassment or shame due to the sensitive nature and potential permanency of images. No studies we are aware of explore reactions to participating in research after this type of crime. Telephone interviews were conducted with convenience samples of parents (n = 46) and adolescents who were victims of child sexual abuse (n = 11; some of whom were portrayed in sexual abuse images), and online surveys were completed by adult survivors depicted in abuse images (N = 133). The first lesson was that few agencies tracked this type of crime. This lack of tracking raises the question as to what types of data should be collected and tracked as part of an investigation. The second lesson was that few victims at the two participating agencies had been portrayed in sexual abuse images (4%-5%). The third lesson was that once possible cases were identified, we found relatively high percentages of consent to contact and interview completions. This implies that researchers and service providers should not be hesitant about conducting research after an investigation of child sexual abuse. The fourth lesson was that the vast majority of participants reported not being upset by the questions. We hope that the data presented here will encourage agencies to reconsider the types of data being tracked and will encourage researchers to conduct in-depth research with populations that are often difficult to reach to continue improving the professional response to child victimization.

Keywords

child sexual abuse child pornography children’s advocacy centers methodology/methodological issues sexual abuse images

The production of child sexual abuse images has long been a concern to advocates, policymakers, and the public. U.S. federal law states that “any person who employs, uses, persuades, induces, entices or coerces” a minor to engage in sexually explicit conduct for the purpose of producing an image of such conduct commits a felony (18 USC 2251). Many states mirror federal law, although there is some variation in the definition of child and the content that is proscribed. In 2009, U.S. law enforcement agencies made an estimated 1,910 arrests for crimes that included the production of child sexual abuse images, more than double since 2006 and almost 5 times as many as in 2000 (Wolak, Finkelhor, & Mitchell, 2012). The National Center for Missing & Exploited Children (NCMEC) operates the Child Victim Identification Program, which assists law enforcement in locating child victims in abusive images. Since the program began in 2002, more than 147 million images and videos have been reviewed and more than 9,600 child victims have been identified (NCMEC, n.d.). With increasing arrests for this crime, the criminal justice, child protection, and mental health response systems often struggle with how best to respond to victims portrayed in sexual abuse images (Martin & Alaggia, 2013; von Weiler, Haardt-Becker, & Schulte, 2010).

Although there has been tremendous progress in research and practice regarding other types of child sexual abuse, far less is known about the impact on and response to victims whose sexual abuse is documented in images that, in some cases, may be circulated in perpetuity. Counselors who worked with such victims in Germany have reported that for some, once they grasped the permanence of the images, they felt a loss of control, powerlessness, helplessness, shame, and fear. The counselors believe this fact of permanence was a heavy extra burden in trying to cope with and find closure (von Weiler et al., 2010). The fact that some images may be accessed online by anyone at any given time may exacerbate the impact of the abuse on victims (Martin & Alaggia, 2013; Palmer, 2005).

The current article is part of a larger project to analyze the legal rights of victims portrayed in sexual abuse images, to examine their service needs and barriers, and to explore promising practices for responding to this crime (Howley et al., 2014). The goals of this article are to describe lessons learned conducting research with this population and to highlight implications for future research. Because we know of no other research that has collected this type of data, we hope that our experience will inform future research initiatives with difficult-to-reach populations.

Recruitment Process

Parents and Children

The purpose of the telephone interviews with parents and children was to identify the needs of victims portrayed in sexual abuse images and their families, collect details about the services they received, and learn about barriers they may have experienced. Telephone interviews were conducted with parents (a) whose children had forensic interviews at two Children’s Advocacy Centers (CACs) or (b) were members of a parent support group that agreed to recruit members to participate in the survey. Parents included both those whose children had been depicted in sexual abuse images and those whose children had experienced sexual abuse but had not been photographed, with the goal of comparing the experiences of the two groups. In addition, we conducted telephone interviews with children aged 13 to 17 whose parents consented and who agreed to participate.

All procedures were approved by the University’s Institutional Review Board (IRB). The interviews lasted approximately 30 to 45 minutes for the parents and 10 to 15 minutes for the children. Parents received US$40 gift cards, and teen participants received US$20 gift cards. At the end of the interviews, all participants were offered toll-free phone numbers of support services. Responses were recorded using Qualtrics. Interviews were conducted from November 2012 to August 2013.

Agency staff first contacted parents by phone or email and explained that participation was voluntary and would not affect their child’s status at the agency in any way, that responses would be confidential, and that agency staff would not have access to responses. Staff then asked whether parents would consent to being contacted by researchers about the study. When parents said yes, staff forwarded consent forms with contact information to the researchers. Researchers then called interested participants to schedule a time to describe the study and ask whether parents would like to participate in the study.

The sample of parents (n = 46) included parents who reported their children were victims of child sexual abuse that included portrayal in sexual abuse images (n = 13) and parents whose children were sexually abused but not photographed (n = 33). Based on parent reports, the sample of child victims (n = 11) included three adolescents who had been photographed. In this report, we do not distinguish these adolescents because the sample size was too small.

Adult Survivors Depicted in Sexual Abuse Images

The purpose of the online survey with adult survivors depicted in sexual abuse images was to understand (a) the impact the images have had on victims, (b) victims’ experience with counseling, (c) experiences with the judicial system, and (d) what helped or did not help from service providers. Several victim service organizations and support groups with a focus on adult survivors of child sexual abuse agreed to send email invitations to listserv members and/or post invitations on their websites. Respondents who answered yes to the following question continued with the survey:

Just to confirm, are you an adult (age 18 or older) who was pictured in child pornography? Child pornography refers to images (pictures or videos) of minors age 17 or younger that depict explicit sexual acts, focus on genitals or show nudity in a sexual context. The perpetrator may have created the images or may have convinced the child to create them.

The survey took an estimated 15 minutes to complete. All procedures were approved by the University’s IRB. The survey was open from January 9, 2013 to September 30, 2013. The sample consisted of 133 participants.

Lessons Learned and Implications

Because CACs reach so many child sexual abuse victims, the membership agency of CACs, the National Children’s Alliance, was a collaborator on this project and actively involved in the recruitment process. The first lesson was that the vast majority of CACs and other agencies we reached out to were not consistently tracking whether child victims had been photographed for sexual abuse images. To recruit CACs, the National Children’s Alliance issued invitations to 30 urban CACs using emails, phone calls, and face-to-face recruitment efforts. Urban CACs were specifically recruited to help ensure a large enough sample size. The typical CAC serves approximately 400 children per year; urban CACs may serve 1,000 to 2,000 children. Of the 30 urban CACs asked to participate, only six responded that they could identify cases that might qualify for the study. The remaining CACs replied that although they encountered these cases, they did not track them as a distinct abuse type. Some said that they considered depiction in sexual abuse images to be one end of a very long continuum of abuse and did not specifically record it. Others mentioned they did not have the ability to search their electronic records specifically for it. Ultimately, only one of the six urban CACs participated. Informal recruitment efforts were extended to additional CACs that had relatively large populations and good case tracking systems in place, which resulted in one additional CAC participating in the project.

Some CACs work very closely with the Internet Crimes Against Children (ICAC) Task Force Program, which helps state and local law enforcement agencies develop an effective response to technology-facilitated child sexual exploitation and Internet crimes against children. This includes organizing forensic and investigative components, training and technical assistance, victim services, and community education. Even those CACs that worked with ICAC programs (some right in the same building as the CAC) were not able to identify cases for this research project because the records did not include separate tracking for this population.

In an effort to supplement the number of participants, recruitment was extended to three rape crisis centers that were informally known to work with this population. Administrators at each expressed enthusiasm and a belief that they were serving many child victims and families impacted by depiction in sexual abuse images. However, similar to the CACs, they were not able to systematically track and identify eligible families to participate in the study.

This lack of tracking raises the question as to what types of data should be collected and tracked as part of a child sexual abuse investigation. Many CACs use computer-based case tracking systems, such as NCAtrak, that potentially offer a systematic way to track detailed aspects of cases. The NCAtrak system, for example, offers site-specific modifications to track variables of interest. Although use varies tremendously across CACs, future research endeavors should explore the potential for this system, or others like it, to expand the types of data collected (Walsh, Jones, & Swieciki, 2014). Agencies could consider capturing whether sexual abuse images were generated as part of the crime, whether they were disseminated, and by whom. Better tracking of the characteristics of cases seen could help to improve the types of services offered by CACs and their partner agencies.

The second lesson was that depiction in child sexual abuse images was a relatively rare occurrence at the two CACs we worked with. One CAC was not able to distinguish between victim exposure to or production of such images in their case records. At this CAC, according to case records, 2.7% of the 2,800 children who received forensic interviews and 5.2% of the 1,470 children with a sexual abuse disclosure had been either exposed to or depicted in sexual abuse images. At the second CAC (which could specify production of sexual abuse images), 1.4% of the 2,165 children who received forensic interviews and 4.3% of the 691 children who had experienced sexual abuse had been depicted in such images according to case records. This meant that the initial pool of possible cases was relatively small.

The implication is that although this was a relatively rare occurrence at these two CACs, more data are needed on how prevalent depiction in sexual abuse images is across child sexual abuse cases. These estimates are some of the first that we are aware of, in part because of the difficulty tracking specific characteristics of the abuse. Because of the potential permanency of images and shame due to the sensitive nature of the images, additional data on the extent to which children endure this particular type of abuse could provide information on the variation of experiences, which could help inform the development of support and intervention services.

The third lesson was that once possible cases were identified, we found a relatively high percentage of parents (48% to 57%) agreed to have researchers contact them about participating in this study. This is noteworthy because organizations working with families sometimes assume that after an investigation of child sexual abuse, families may be reluctant to talk to researchers. This reluctance could be heightened for families with children portrayed in sexual abuse images because of the extremely sensitive nature of these cases. Yet, we found a similar consent to contact rate of 48% for cases of child sexual abuse both with and without the production of images at the one CAC where we could compare response rates. Few parents said they were not interested in participating in the research (15%). The challenge was being able to reach parents to ask for consent—there was no answer for 21% of parents and wrong phone numbers for 17% of parents. Furthermore, the majority of parents who consented to be contacted by the researchers actually completed telephone interviews (66%, 35 out of 53). The participation rate was consistent across both groups (child sexual abuse with and without production of images). The US$40 incentive parents received for participating may have played a role in the relatively high rate of completed interviews, although many parents expressed that they were interested in participating due to the potential to help others. In addition, the majority of parents of 13- to 17-year-olds (77%, 17 out of 22) agreed to have researchers contact their children about the research project.

The implication of the high levels of consent to contact and interview completion is that researchers and service providers do not need to be hesitant about conducting research with families after an investigation of child sexual abuse, or one that involves production of sexual abuse images. This is encouraging because anecdotally many service providers often protect families with whom they are in contact from participating in research. As others have noted, more and better research is needed to help improve the system response to this type of crime (Finkelhor & Ormrod, 2004).

The fourth lesson was that the vast majority of participants felt that it was very important to participate in research like this and reported not being upset by the questions. At the end of the telephone survey, we asked a number of questions about parents’ and victims’ experience participating in the research (see Table 1). All parents and adolescents said it was very or more than a little important to participate in research like this to help other families who have experienced these kinds of problems. The majority of parents and all of the adolescents said the questions were not at all upsetting. All parents and adolescents said that they would still have agreed to do the interview knowing what was in the survey (one parent chose to skip several questions due to time constraints, including this question). Given the potential reluctance to participate, it is important to note that numerous parents also made spontaneous remarks that they appreciated having the chance to participate and were glad that someone was making the effort to research this issue.

Table 1.

Experiences Participating in Research About the Production of Child Sexual Abuse Images.

	Parents of Victims of Sexual Abuse Imagesn = 13% (n)	Parents of Victims of Child Sexual Abuse(No Images)n = 33% (n)	Adolescents Who Experienced an Investigation of Sexual Abusen = 11% (n)	Adult Survivors of Sexual Abuse ImagesN = 107^a % (n)
How important to participate in research like this
Not at all important	0 (0)	0 (0)	0 (0)	1 (1)
A little important	0 (0)	0 (0)	0 (0)	5 (5)
More than a little important	8 (1)	6 (2)	18 (2)	7 (8)
Very important	85 (11)	94 (31)	83 (9)	82 (88)
Missing	8 (1)	0 (0)	0 (0)	5 (5)
How upsetting were questions in survey
Not at all upsetting	69 (9)	85 (28)	100 (11)	56 (60)
A little upsetting	15 (2)	12 (4)	0 (0)	12 (13)
More than a little upsetting	8 (1)	3 (1)	0 (0)	14 (15)
Very upsetting	0 (0)	0 (0)	0 (0)	5 (5)
Don’t know	0 (0)	0 (0)	0 (0)	11 (12)
Missing	8 (1)	0 (0)	0 (0)	2 (2)
Knowing now what was in the survey, would still agree to participate
No	0 (0)	0 (0)	0 (0)	0 (0)
Yes	92 (12)	100 (33)	100 (11)	94 (101)
Don’t know	0 (0)	0 (0)	0 (0)	5 (5)
Missing	8 (1)	0 (0)	0 (0)	1 (1)

Questions asked 2 weeks after survey was first made available. Twenty-six respondents had already completed the survey and thus did not answer these questions.

The majority of the adult survivors portrayed in sexual abuse images who completed the online survey also believed that this type of research was very important (see Table 1). It is important to keep in mind that for 83% of the adult survivors, the crime occurred more than 10 years ago, and only 17% of adult survivors said that there was a police investigation.¹ Some adult survivors described the questions as very upsetting (5%) or more than a little upsetting (14%). Despite possibly being upset, nearly all respondents said that they would still agree to participate knowing what was in the survey. At the end of the survey, respondents had an opportunity to share anything else they wanted to with the researchers. Some of the answers included the following:

More like unsettling, not upsetting. Emotions came to the surface and I had to face my reality. Thanks for this questionnaire. Hope you will make the results known!!

Thank you for doing this type of research. It is hard to be a survivor of this type of abuse.

Despite it being upsetting to answer, I am very very glad that this survey is being done and that I am able to take part in it. I’m very grateful you are doing it and I’m also glad (despite it being hard) to have some space where I could be “real” about my feelings about this.

I am so glad this issue is being taken more seriously now, and it is more known how common this is.

The positive response about participating in this research mirrors results of national studies of all youth that find that few children report being upset by survey questions (Finkelhor, Vanderminden, Turner, Hamby, & Shattuck, 2014; Radford, Corral, Bradley, & Fisher, 2013; Zajac, Ruggiero, Smith, Saunders, & Kilpatrick, 2011). Furthermore, many youth, not unlike adult participants, appreciate the opportunity to help address the problems of victimization by participating in research (Newman, Risch, & Kassam-Adams, 2006; Preibe, Bäckström, & Ainsaar, 2010).

The implication of such a positive response from victims and parents means that researchers and IRBs should avoid the misconception that conducting research with parents of and victims of child sexual abuse is necessarily causing additional distress (Finkelhor, Hamby, Turner, & Walsh, 2016; Finkelhor et al., 2014). Nonetheless, investigators should have a protocol to respond to upset respondents. In this study, for example, we offered toll-free phone numbers for support services to all participants. Some studies engage clinicians trained in telephone crisis counseling to follow-up with respondents (see, for example, Finkelhor et al., 2014), so this could be another option to address any concerns about participant distress. More research is needed on whether such protocols can help alleviate survey-related distress.

In conclusion, it is important to keep in mind that our sample is not representative of all child victims portrayed in sexual abuse images. We had a relatively small sample of cases from two agencies and a convenience sample of adult survivors of child sexual abuse images. If agencies working with child victims begin to more consistently track the production of child abuse images, future research will be able to obtain representative samples. Clearly, much more research is needed to understand the extent of this type of crime, the characteristics of victims with the production of images compared with non-image cases, such as age, race, socioeconomic status, and relationship to perpetrator. Future research could also examine unique aspects of this type of crime, such as how forensic interviewers and counselors can work with victims who are not aware of the images, how to improve access to support services for victims who may be reluctant, and how to ensure that victims are not revictimized by the criminal justice response. We hope that the data presented here will encourage agencies to reconsider the types of data being tracked in their databases and will encourage additional research with populations that are often difficult to reach to continue improving the professional response to child victimization.

Footnotes

Acknowledgements

The authors gratefully acknowledge the time and willingness of the respondents to participate in the study.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Grant No. 2011-VF-GX-K017 awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. Points of view or opinion in this document are those of the author(s) and do not necessarily represent the official opinion of the Office for Victims of Crime.

Notes

Author Biographies

Wendy A. Walsh, PhD, is a research associate professor at the Crimes Against Children Research Center at the University of New Hampshire. Her research focuses on evaluating child abuse prevention and intervention programs and examining the criminal justice response to child abuse. She is the author and co-author of numerous articles about child victimization and service use, the impact of victimization, and children’s advocacy centers.

Janis Wolak, JD, is a senior researcher at the Crimes Against Children Research Center, University of New Hampshire. She has directed several U.S. national surveys about crimes related to the Internet, including CP production. She is the author and co-author of numerous reports, book chapters, and peer-reviewed articles about youth victimization, child pornography, and Internet-related sex crimes.

Kaitlin Lounsbury, MA, is the outcome measurement system coordinator for the National Children’s Alliance. She has also worked on research projects at the Crimes against Children Research Center at the University of New Hampshire, focusing primarily on child sexual abuse.

Susan Howley is the public policy director for the National Center for Victims of Crime. For more than 20 years, she has worked to improve the nation’s response to victims of crime.

Tonya Lippert, PhD, LCSW, works for Kaiser Permanente running mental health therapy groups and conducting forensic interviews with children and teens who may have been abused. Her research interests include childhood abuse and mental health.

Lawrence Thompson, Jr., PhD, is the director of Therapy and Psychological Services at the Harris County Children’s Assessment Center, Houston, Texas. He oversees the provision of mental health services to child sexual abuse survivors and family members, court consultation, and expert testimony in child sexual abuse cases.

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