47 PREVENTION AND INTERVENTION Introduction A third Workshop consensus session focused on methods for mitigating the negative effects of pornography. Two general topics were considered: 1.) preventing the negative effects that have been shown or hypothesized to occur when children and adolescents view pornography, and 2.) providing intervention services to children and adolescents who are at risk for becoming involved or are already involved in the production of pornography. Achieving any success in either of these tasks will require the integrated efforts of individuals from several academic disciplines, the media industry, and government. This section provides general ideas about prevention strategies in these two areas. There is no call for the abolition or censorship of certain materials. The question of banning materials was not considered an appropriate one for discussion by the Workshop participants, since it involves issues that go well beyond the scope of social science. Instead, participants worked on proposing methods of prevention that could be usefully pursued under the assumption that pornographic materials will continue to be a possible influence on the development of children. Only general directions for programs can be presented at this time, however, and specific prevention programs will have to be developed according to the goals and resources of those involved in later efforts. Separate programs will need to be developed for youth of different ages and backgrounds, and the level of cooperation received from parents and professionals will obviously limit the types of strategies that can be pursued. In this regard, it should be remembered that bigger, more elaborate programs do not always make better programs. There is such a dearth of information regarding prevention in this area that there is a great need for carefully evaluated pilot programs. Information gained from these efforts can make the design and implementation of larger scale projects more effective. What is needed now is a concerted effort to undertake programs that make theoretical and operational sense and to document carefully the effects of such efforts. 48 Prevention of the Effects of Exposure: Two Approaches Particular concern should be focused on the prevention of the possible effects associated with violent sexual material. This material is defined as that in which explicit or nonexplicit sexual activity is either accompanied by violence (as in a rape depiction), is juxtaposed with violence (as when a woman is harmed immediately after sexual activity), or is otherwise linked to violence (as when the same musical theme occurs during both a sexual scene and a later violent scene). Prevention of effects of violent sexual material are targeted as worthy of serious concern because evidence from current research indicates a clearer link between viewing this particular material and consequent undesirable changes in beliefs and patterns of thinking about women and sexuality. Prevention of the possible effects of this growing aspect of the pornographic materials market is the most fruitful place to begin in order to make a substantial impact regarding possible negative effects on children. Two general approaches to the limitation of negative effects of exposure to violent sexual materials are advocated. The first is to provide parents (and children) with cues to sensitize them to the materials that should be watched with caution. The second approach is to provide a framework of media literacy for viewing these materials that might limit the harmful effects of exposure. Done in unison, these two primary prevention approaches could promote careful choice of materials for child and adolescent viewing and a way of "innoculating™ youth who do see potentially harmful materials. First Approach: Cues Regarding Materials Content labeling of movies would be one method for providing valuable information to parents and youth regarding materials that may have harmful effects on attitudes. It is generally impossible to ascertain the types or amount of violent or sexual content in movies by either their title or their ratings. This can be especially troublesome for parents who do not want to appear to condone a particular type of behavior by allow- ing their children to see a movie in which it occurs, either at a theater or at home. 49 Therefore, it would be useful for the movie industry to extend its current labeling of movies (G, PG, PG-13, R and X) to include more easily understood terms that would be used industry-wide. Not to be confused with "warning labels", these labels would simply identify contents of the movies that some may wish to avoid. They would appear on advertise- ments for the movies and on the covers of movie cassettes. Examples of these labels can be found in a variety of television and cable movie guides (e.g., nudity, violence, adult situations, language). The purpose and orientation of this content labeling approach is educational. It is primarily intended to make parents aware of the scenes that form the core of the films to which their children could be exposed. In the end, no labeling system or categorization scheme can be totally effective in limiting exposure of youth to par- ticular types of materials. Recent survey research by Greenberg (in progress), for instance, shows that many of the most popular R-rated films had been seen in movie theaters by a majority of 14-15 year olds in a broad sample. While it is unclear how many more youth may have seen these films if there were no rating system, this re- search points up the validity of the common sense conclusion that responsibility for restrictions on viewing of certain materials rests heavily with the family or the youth. With this in mind, it would seem useful to provide as much information about the con- tent of movies as reasonable so that an informed choice could be made. An additional method for highlighting the possible negative effects of certain materials is to schedule the television showing of these materials only at times that children would be least likely to see them. Some cable networks broadcast nonexplicit violent sexual movies during times when young children can easily watch them. Based on research findings reviewed earlier, it is reasonable to assume that repeated expo- sure to these materials during regular viewing hours conveys the message that the relationships or activities seen in these movies are common in the real world. Merely showing these movies exclusively during hours when most children are not normally awake could limit the exposure and subsequent effects on children's beliefs. While this restricted scheduling cannot prevent children from watching these movies, the fact that the children would have to break their normal patterns to watch them could rein- force the idea that the contents do not reflect frequently occurring behaviors, and the formation of improper beliefs from these movies might therefore at least be partially discouraged despite the viewing. As mentioned previously, the ultimate responsibility for children's exposure to potentially harmful sexually violent materials currently rests with the family. These two rather nonintrusive measures would help the family to perform this function. Increased information about film content and restricted showing times could focus the 50 efforts of parents and guardians who are presently assuming that no such preventive measures implies no possible harm from these materials. Second Approach: Media Literacy The second major strategy for limiting any harmful effects on children of exposure to violent sexual materials is to increase the capacity of children to withstand any possible negative effects of exposure to these materials. If one takes as a given that limiting exposure can only be done with marginal success because of the easy access to media with sexually violent themes, it then becomes imperative to explore the pos- sibility of teaching children, adolescents, and adults to evaluate critically the contents of media presentations and to be aware of the effects that certain presentations can have on beliefs and attitudes. Using existing institutional structures, adults and children could be educated about these issues in broadly based programs designed to teach consumers about the media. There is reason to believe that a media literacy program regarding the effects of violent sexual material could be effective, based on the results of several studies that have examined ways to counteract influences connected with exposure to these materials. Several studies ({e.g., Check & Malamuth, 1984; Malamuth & Check, 1984; Krafka, 1985; Donnerstein, 1986) have shown that presentations outlining the ways that violent sexual material can foster or reinforce incorrect beliefs or negative attitudes have been able to prevent the expected results of exposure. In other words, educating people about the possible effects of exposure, in conjunction with exposure, appears to reduce or eliminate the shifts in attitudes that are usually seen after exposure. These presentations have generally been given to groups of college students who had recently watched one or more violent sexual movies. The ways that their beliefs may have been affected by the movies were demonstrated by showing them a scene from a violent sexual movie and highlighting the particular false belief that it supports. For instance, showing a scene in which a woman who is being raped even- tually appears to be aroused by the experience and noting that this supports the incorrect belief that women generally enjoy being raped has been shown to reduce the acceptance of that belief. While this type of presentation is not appropriate for all children and adolescents, it may be appropriate for older adolescents and may be adapted to be useful with younger children as well. What is impressive and potentially use ful about these research findings is the demonstration that youth may be able to be 51 "innoculated" against these influences through a carefully planned exposure to materials. Careful use of the very material that one may want to restrict access to may hold the key for ensuring that harmful effects are minimized when inevitable exposure does occur. While this approach could be adapted and integrated into a school curriculum or organizational program effort, broader media literacy approaches could also be undertaken. Television and radio, for example, could be influential in promoting attitudes that counteract those possibly fostered by exposure to violent sexual media. Research by Greenberg (in progress) has indicated the popularity with adolescents of many of the night-time situation comedies and afternoon soap operas. Several of these programs have included epsicdes which promote the beliefs of equality, sensitivity to others, and social responsibility, and which illustrate some of the negative aspects of attitudes like those that may arise from viewing violent sexual material These shows are to be commended for their efforts to promote positive atti- tudes, and steps could be taken to make public commendations to that effect. The Surgeon General, other public figures, or the media industry could give an award regularly for programming that promotes positive sexual attitudes and provide favor- able publicity to these shows as a result. It would be hoped that such recognition would encourage the inclusion of these themes in a systematic manner into the format of other shows. Finally, other direct efforts using media could be made. Public service an- nouncements which reinforced attitudes counter to those which condone sexual ag- gression could be of use. Also, radio programs could integrate material related to attitudes toward sexual coercion into their programming. This could be done effec- tively by including media-literacy themes into programs that are popular with children and adolescents in which listeners phone in and speak with a mental health profes- sional. The purposes of this broad media literacy effort would be to sensitize the public to the presence of particular attitudes and to warn them about the possible mechanisms which could promote these attitudes. This approach makes sense as an application of a positive strategy that has been used in curbing cigarette smoking and combatting drug abuse. Educating people empowers them to do something about a problem, and providing information about the development of attitudes toward sexual coercion could be the most effective long term tactic in countering the harmful effects of exposure to violent sexual pornography. 52 Before leaving the question of prevention of harmful effects of exposure, a sec- ondary prevention strategy that should at least be mentioned here is that of early identification. Some research has indicated the possibility that adolescents and adults who are sexually aroused by depictions of violence, or who regularly have sexual fan- tasies involving high levels of violence, are at a higher risk for coercing someone else to engage in sexual activity. This screening information could be of potential value both to youth experiencing such arousal and to adults to whom they might turn for counsel. Discussions about their arousal patterns could help these youth to feel more comfortable with their sexuality and may help to reverse thinking patterns or beliefs influencing behavior in undesirable ways. At the same time, it is obvious that this information could also be very dan- gerous in promoting labeling. The overall prevalance and normaley of these patterns of arousal among those who never are coercive is not known, and suggesting to youth who have them that they are destined to become sexually coercive may encourage such behavior in individuals who otherwise would not engage in it. As a result, any such efforts at early identification of adolescents with arousal patterns related to violence would have to be handled with extreme care, and would probably be best be- gun after additional research on the development of these patterns has been done. Presently, inclusion of the information that certain individuals may be aroused by violence as part of general educational approaches would seem appropriate, but iso- lation of individuals with such arousal patterns would seem premature. Prevention of the Effects of Involvement Preventing children's involvement in the production of pornography and intervening with those who have been involved presents a formidable challenge to child protection agencies, social service providers, mental health professionals and legal authorities. General prevention and intervention strategies are presented here, but, as in the pre- vious discussion, there is no detailed consideration here of the steps that could be taken by enforcement agencies to combat this problem. Providing general statements and observations about prevention strategies was a sufficient challenge for the Workshop participants. As a first step in focusing efforts and gathering valuable information for the design of future prevention programs, efforts to locate and aid those youth currently involved in the production of pornography must be increased. This effort would in- 53 elude encouraging child protection and mental health agencies to develop clearer methods for accurately identifying these youth, disseminating this information to ap- propriate adults (e.g., parents, teacher, physicians, mental health professionals), and encouraging the reporting of these youth to the appropriate public agencies. This proactive strategy of case finding and service provision would be a humane way to prevent ongoing victimization of children, to gather badly needed information about the dimensions of this problem, and to educate professionals about the methods used for involving children in this activity. The importance of providing mental health services after disclosure of involvement in the production of pornography is underscored by research done by Burgess and her colleagues. In a study of a sample of youth involved in pornography rings (Burgess et al., 1984), these investigators found an exacerbation of symptoms after disclosure of involvement. In addition, it was found that ‘many children did not receive mental health services after disclosure of their activities. Given these two findings, it appears imperative that services at least be made available and strongly encouraged for youth immediately after disclosure. It is at this time that the youth would be in the most volatile state regarding the meaning of involvement, and this opportunity should not be missed to help provide the youth with a framework for viewing this situation. Programs to prevent children's involvement in the production of pornography should be established simultaneously. Of central importance to the planning of these preventive intervention efforts should be the recognition that the youth who are likely to be involved in the production of pornography almost invariably have multiple interpersonal and family problems. These are not youth with a clearly identifiable, singular problem that makes them “at risk." Instead, most of these youth end up involved in pornography as the result of a tragic chain of events that has stripped them of standard support structures during a developmental period when these supports are essential Research has shown that most of the children and adolescents involved in the production of pornography have run away from or been forced to leave their home and turn to pornography as a way of surviving. Others have become emotionally abandoned by their families and turn to those involved with pornography for emotional support (e.g., see Burgess & McCausland, 1984; Silbert & Pines, 1984). The merging of opportunity, situational need, and lack of emotional attachment foster involvement, and this means that it is unrealistic to think of identification of high risk youth in this area in terms of any particular personality measures. There are : a large number of homeless or emotionally abandoned youth who are "at risk" largely 54 by virtue of their life situation. These are the youth who must be targeted for prevention efforts. , A corollary of this premise regarding identification is that services in this area are also not providing a clear remedy for a disorder. Instead, they are competing with the producers of pornography for contact with an alienated and disenfranchised group of young people. As a result, the key to involvement with these youth is the provision of the same things that the producers of pornography use to lure youth into this activ- ity: emotional engagement and financial support. Programming, therefore, must be creative and adaptive, and cannot afford to be professionally parochial Establishing a working relationship with these youth is a difficult task; one that requires active outreach and a variety of services offered by a community-based umbrella agency. Establishing and maintaining contact early on in a youth's experience on the street, however, appears to be a critical component to success. Clinical reports consistently document the callousness and defensiveness that accompanies continued exposure. It is during the initial period that these youth are most susceptible to influence from either service providers or those interested in using these youth. As an adolescent finds contacts and builds an awareness of what it takes to survive on the street, it becomes increasingly difficult to propose an alternative. The known is at least predictable, and it is hard to believe that any proposed arrangement will really work out any better than the present situation. Providers attempting prevention in this area must be prepared to offer more than just a single service (such as counseling) and must be prepared to be on the street rather than in an office. A component of these programs would include reuniting some of the youth with their families. Other youth who are unable or refuse to return to their families should be given shelter and emotional support, taught independent living skills, given vocational and traditional education, and provided with the opportunity to establish independent lives. This is a tall order for any service, but multifaceted programming is critical, given the myriad of needs that can be present with this broad at-risk group. This lack of a clear singular service may be in conflict with the predominant trend toward specialization and professiona lization in mental health care provision. In many ways, what is being advocated is classic street social work combined with an or- ganzational plan for a multi-purpose alternative setting. Starting where the client is appears to be critical in this area, however, and this means that the lines between mental health services, education, and provision of material needs must often become blurred when working with these youth. In summary, what is being highlighted here is the need for innovative programs 55 to address the particular needs of a broad group of disenfranchised youth who are like- ly victims for involvement in the production of pornography. General calls for preven- tion in this area can be made, but the reality of the situation is that someone has to go onto the street and establish programs that appeal to the youth there. These programs cannot be of the traditional model of mental health service provision merely located in a rundown neighborhood. They must involve settings with a wide range of services and clear sense of mission. Establishing and maintaining them will be a true chal- lenge, but one that must be undertaken if the flow of children into the pornography industry is to be curtailed.