Recognition of the physical abuse of children set the stage for not only the acceptance that CSA was a social problem but also the need for prevention (Burgering, 1994). The catalyst for transforming this awareness on CSA was the emergence of radical feminism and the child protection lobbyists' during the 1960s-1970s in the United States (Wurtele & Miller-Perrin, 1992; Burgering, 1994). Public awareness to the problem mushroomed through retrospective disclosures by female survivors of CSA revealing the impact of their childhood sexual victimisation, as well as the proliferation of prevalence studies by De Francis (1969), Finkelhor (1979), and Russell (1983), demonstrating that CSA was not rare (Plummer, 1999; Myers, 2011). Reports of abuse were helped along by the 1974 Child Abuse Prevention and Treatment Act, which saw an increase of 150 percent from the mid-1970s to the early 1980s (Berrick & Gilbert, 1991, in Plummer, 1999). Furthermore, CSA received unprecedented media exposure detailing horrific satanic and mass abuse cases within day-care centres (Wurtele & Miller-Perrin, 1992). These interlacing factors not only propelled public knowledge on CSA, but also provided scientific support on the reality of the problem (Wurtele &Miller-Perrin, 1992). The convergence of reporting laws, public and professional responses, and victim accounts made the time for CSA prevention right (Plummer, 1999), as for the first time, SA was recognised as a problem that affected the lives of many (Hana, 2005).
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Efforts to overcome centuries of silence and help prevent CSA resulted from a change in attitudes generated by challenging the existing power and sexist beliefs within society, but also the need to protect vulnerable children (Meyer, 2000). In response to the increasing size and repercussions of CSA, primary prevention programs were established in the late 1970s and distributed from the 1980s in the United States (Plummer, 1999; Wurtele, 2012). However, the pressure to respond to this abuse meant that interventions developed faster than research commissioned, meaning that initiatives were not rigorously tested (Meyer, 2000; Bolen, 2001). Initial child-focused prevention efforts adapted from what had been learned from rape prevention, focusing content on the idea of stranger danger (Plummer, 1999; McPhillips, Berman, Olo-Whaana, & McCully, 2002). However, the continuation of research with offenders and victims recognised that children were at a greater risk of being abused by those they already knew, and therefore programs expanded to include other potential offenders (McPhillips, Berman, Olo-Whaana, & McCully, 2002; Wurtele & Miller-Perrin, 1992). Prevention efforts primarily sought to equip children with the knowledge and skills needed to minimise the risk of sexual abuse through group-based personal safety learning (McPhillips, Berman, Olo-Whaana, & McCully, 2002; Wurtele, 2012). These school-based interventions taught children the distinction between good/bad/questionable touching, the concept of body ownership and assertiveness, but also to increase disclosure (Wurtele & Miller-Perrin, 1992; Child Welfare Information Gateway,2011). Schools were, and remain, the setting for the universal education due to its key role of informing, the ability to reach the majority of children from different ethnicities, racial, and socio-economic backgrounds, relatively cost-effective, and removes the stigma attached to the possibility of victimisation (Wurtele, 2012). Nevertheless, prevention programs were targeted at the portion of the population that could be harmed, as more was known about the possible victims than whom the offenders actually were. Therefore, early primary prevention efforts that have continued through to today targeted the reduction of victimisation instead of the reduction of the offending behaviour itself (Wurtele & Miller-Perrin, 1992).
At the opposite end of the continuum is treatment programmes for sex offenders. These tertiary prevention interventions used in United States and New Zealand today took form from the 1960s (Beggs, 2008). Prior to the remediation of sex offenders through the cognitive-behavioural approach, psychoanalytic therapy was the favoured approach to deal with sexual offending (Marshall, Anderson, & Fernandez, 1999). The behavioural modification of sexual preferences focused on adjusting deviant sexual interests (in this case being aroused by children) through positive and negative reinforcement to amend the problem behaviour (Fernandez, Shingler, & Marshall, 2006; Beggs, 2008). However, the multi-faceted and heterogeneous nature of the offending became known in the 1970s, and treatments began to incorporate further elements such as cognitive reformation, social skills training, and empathy development (Ward, Polascek & Beech, 2006; Beggs, 2008). Since then, tertiary prevention has continued to progress with theoretical developmets. The risk-needs-responsivity principle argues that as sex offenders are considered high-risk they would benefit the most from intensive programmes, the need principle advocates that the criminogenic needs of the sex offender need targeting, and the responsivity principle states that treatment needs tailoring to the offenders learning style and ability (Andrews & Bonta, 2010; Willis, 2009; Beggs, 2008). Additionally, the relapse prevention model (Laws, 1989) has also influenced modern treatment programmes by teaching sex offenders to identify that their offence chain can be broken and how to recognize and avoid high-risk situations by adopting coping mechanisms (Beggs, 2008). Therefore, the cognitive-behavioural approach is regarded as the most effective for treating all sex offenders as it includes numerous factors (Hanson et al, 2002; Ward, Polascek & Beech, 2006).
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The development trajectory of CSA prevention in New Zealand occurred later than America, with the recognition of CSA as a serious social problem in the mid 1980s (Coldrey, 1996; McPhillips, Berman, Olo-Whaana, & McCully, 2002). Prior to this, professional and public awareness in New Zealand was limited. There were only 16 research articles on CSA between 1966 and 1984 (Phair-Thomson, 1985), but also the omission of CSA figures within social welfare department reports demonstrated the lack of concern (Phair-Thomson, 1985). However, increased research activity, effective lobbying, and the use of overseas literature, successfully contributed to moving CSA from the private to public sphere during the mid 1980s (Burgering, 1994). International programmes therefore influenced New Zealand's primary and tertiary prevention strategies. In regards to primary prevention, New Zealand evaluated and discarded the favoured 'Protective Behaviours' empowerment model in America and Australia. Children failed to identify safe options concerning personal safety with this method (Briggs, 1991), due to the teachers lack of reinforcement and assistance, as well as the use of complex terminology (Briggs, 1991; Briggs, & Hawkins, 1994). New Zealand learnt from the mistakes within the Australian model and provisioned strong social support networks with qualified staff, starting with specially trained police educators on CSA who would then support and train teachers and parents on the prevention program (Briggs, & Hawkins, 1994). The Atascadero Sex Offender Treatment and Evaluation Program influenced New Zealand's tertiary prevention programmes. This rigorous programme for sexually violent offenders focused on cognitive-behavioural intervention (Marques, 1988), but was applied solely to CSA and culturally adapted to respond to the New Zealand context. In particular, programmes have integrated MÄori specific needs to respond to the over-representation of MÄori within the criminal justice system (Van Heugten, 2006; Willis, 2009).