(German) Journal of Sex Research Vol. 5, Issue 1 (41-55) (March 1992)
How Preventive Are Child Sexual Abuse Prevention Programs?
A Critique of School-Based Prevention Models in the United States
Natascha Wehnert-Franke, Hertha Richter-Appelt, and Christine Gaenslen-Jordan
Abstract: In the United States, school-based programs are regarded as a very promising avenue for preventing child sexual abuse. The authors provide a critical overview of these primary prevention-oriented models. The focus, moreover, is on the "Child Assault Prevention Project" The authors are especially critical of the simplification of abuse situations, as well as the abstract language used to discuss sexuality that typify these programs. The authors are also dubious of the concept of empowerment, which is supposed to encourage and strengthen the potential victim. Despite the uncritical adoption of American prevention programs, there needs to be a re-thinking in Germany of primary prevention concepts with regard to preventing sexual abuse.
Keywords: Child Sexual Abuse; Sexual Abuse Prevention; Sex Education
The idea of sexual violence being done to a child -- particularly for those who have their own memories of such experiences -elicits extremely intense feelings of helplessness, rage, and anxiety that are difficult to bear. Correspondingly great is the desire to find a quick fix; to "get a handle on" the problem of sexual abuse, help the children effected by it, and warn others about it. However because sexual encroachments on children take such different forms and have such diverse causes, they cannot be quickly and easily halted through the implementation of simple measures. Whoever seeks to protect children from sexual abuse must also come to grips with feelings of helplessness. Although complete protection will probably never be possible, we can approximate it. At the same time, one cannot avoid the fact that measures to protect children from sexual attack have their own restrictive (i.e., sex-hostile) and therefore unfortunate side-effects.  consequently, preventive work takes place in the tension between the poles of the pressure to take action vs. helplessness, doing nothing vs. restriction, and cover-up vs. incitement to panic.
The problem of the sexual abuse of children was brought out into the open about fifteen years ago by the women's and child protection movements. In Germany, more widespread attention has been paid to it for some years now. Empirical studies on the subject in this country, however, have been rare.
Definitionally, three factors can be described as constitutive of child sexual abuse: a sexual act, a relationship of dependence,. and the goal of the act being the satisfaction of the needs of the more powerful participant. (Hildebrand 1986) Two additional typical characteristics of sexual abuse are a request that it be kept secret and a lack of empathy on the part of the abuser. (Gaenslen-Jordan et al. 1990)
According to representative studies from other countries, predominantly the United states in which adults were retrospectively questioned, 6%-60% of women and 3%-30% of men reported intra- or extra-familial sexual abuse during childhood. (Peters et al. 1986) A critical comparison of such prevalence studies (see Peters et al. 1986) was able to demonstrate that methodologically superior studies brought the above higher proportions of sexual abuse to light. In the first large European study, Draijer (1990), in a representative cross-section of Dutch women, found that 15.5% of all of those questioned reported being sexually abused by a family member prior to age sixteen.
There are, as of yet, no empirically-based figures for the prevalence of child sexual abuse in Germany. Therefore nearly all works on the subject cite the estimate by Kavemann and Lohstoter (1984), according to whom approximately 250,000 girls and 50,000 boys are sexually abused each year in (the former West) Germany. The lone large-scale West German study on this topic comes from Baurmann (1983) who, on behalf of the Federal Police Bureau, studied the situation of sexual victims whose abuse had led to a report and/or conviction. For this he utilized questionnaires, psychodiagnostic tests, and expert opinions as to competency relating to more than 8,000 male and female sexual victims.
Obscured by the concept of "sexual abuse" are some very different kinds of experiences. Probably more than 90% of effected children are sexually abused by persons they know. Unfamiliar perpetrators and exhibitionists constitute only a small portion of cases overall. Approximately every second or third victim is abused by a family member. (Draijer 1990; Finkelhor 1979; Russell 1986). The closer the relationship is between victim and perpetrator, the likelier it is that the sexual abuse will continue over a longer period of time, combined with more serious sexual acts and physical violence. (Baurmann 1984)
Estimates regarding the proportion of boy victims fluctuate wildly. Most authors, however, proceed based on the assumption that girls are up to five times more likely to be  sexually abused. As is the case for girls, boys are, for the most part, abused by men. Male victims, therefore, must also come to grips with the taboo against homosexuality. Furthermore, they are even more likely than sexually abused girls to be overlooked. (Farber et a1. 1984; G10er 1989; Pierce and Pierce 1985) On the other hand, girls are presumably more likely to be blamed for having seduced the adult into the sexual act.
It is difficult to make precise statements regarding the ages at which victims are first sexually abused because, among other things, many retrospectively questioned victims protect themselves from painful memories through amnesia. Whereas retrospective studies on adults have ascertained an average age for the beginning of abuse of approximately age ten, those who work with children proceed based on the assumption that, in most cases, the initial assault takes place during the elementary or primary school ages. (Bentovim and Tranter 1990; McFarlane and Waterman 1986)
The causes of sexual abuse are manifold. According to Finkelhor’s (1984) multi-factoral explanatory model, some of the conditions which, in individuals, can lead to a breakdown of inhibitions and to sexual abuse must be considered. Family dynamics play a role; but social factors also contribute to the perpetrator's environment failing to prevent his actions. And finally, factors within the child and his or her environment, which render him or her more susceptible to or defenseless against sexual assault, have to be considered as well.
On the Concept of Prevention
Where sexual abuse is concerned, prevention can be broken down into three categories:
- Primary Prevention: All attempts to prevent sexual abuse from occurring in the first place fall
into this category.
- Secondary Prevention: What is meant here is the earliest possible disclosure of already-occurring abuse or the termination of a longer history of abuse.
- Tertiary Prevention: This concept covers the proper care and treatment of children who
have become victims of sexual abuse.
Consequently, whereas there are various potential target groups and approaches for preventive work, virtually the only prevention concepts currently being employed are those directed towards potential child victims. Other target groups, i.e., potential adult perpetrators, have scarcely been addressed at all. In the following, therefore, we will limit ourselves to a critical exposition of school-based prevention programs in use at the present time.
Primary prevention work, which focuses directly on children, takes place almost exclusively in the form of so-called programs, carried out in school and in relative isolation from other lesson plans. In these prevention programs, which for the most part were developed in the United States, children are supposed to learn how to prevent their own potential  victimization. Possibilities for preventive work within the context of everyday adult-child interactions (within the framework of the family, school, doctor's office, etc.) have, until now, scarcely been discussed at all.
Secondary prevention, meaning the disclosure of sexual abuse is. as a rule, not formulated as a goal of school-based prevention programs. Nevertheless attempts are made to measure the success of such programs, in part, by the number of sexual abuse disclosures made during or immediately following the program’s presentation. Secondary prevention is, therefore, an implicit goal in at least some of the school programs. (See Anderson 1986; Plummer 1986.)
Tertiary prevention, that is adequate, as needed, therapeutic intervention with children who have become victims of sexual abuse, is neither an explicit nor an implicit goal of schoo1based prevention work. For this, referrals are made to various social service agencies.
Meaningful sexual abuse prevention should, in our opinion, encompass the following:
- the protection of potential and actual victims;
- impeding potential and actual perpetrators;
- information about sexuality and sexual abuse;
- the disclosure of relevant acts; and,
- measures to assist those who become known as victims of sexual abuse.
School-Based Prevention Programs from the United States
Child sexual abuse prevention programs originated in the United States in the late 1970's. Initially developed and carried out by committed volunteers with financial help from private sources, school-based prevention efforts soon become established and promoted in the public sphere. Thus, beginning in 1980, government agencies in the U.S. began to provide funding for the development and implementation of these programs. (Plummer 1986) Within a short period of time, a huge expansion of schoo1based prevention programs took place. In 1986, Plummer estimated that in the United States overall, available prevention materials comprised some forty plays, hundreds of coloring books, and 400-500 additional educational materials. Besides school-based prevention programs, this estimate also included materials that, for example, can be used at home by parents with their own children. These figures made clear that with the development of prevention concepts, a commercial market was also opened up.
Sexual abuse prevention programs are generally geared toward children and youth of both genders, from approximately kindergarten-age on up through grade twelve. Such programs are typically carried out in groups or with an entire class. Some prevention programs for teenagers, which are segregated by sex and thus carried out with differing goals, constitute an exception to this. The special problems this “sex segregation" entails were addressed in detail by Wehnert (1990). The materials with and methods by which  the individual programs strive to provide help vary wildly. Mediums employed include plays and films, books, coloring books, and anatomically-detailed dolls. Methods range from group discussions of role-playing and behavioral modification training on up to self-defense courses. Various combinations of these presentational forms, materials, and methods are also common. (See Conte et al. 1986; Wurtele 1987.) As different and varied as the materials and methods are, however, the content and aims of prevention programs do share the following commonalities:
1. Children are taught what sexual abuse is, albeit to varying degrees of specificity.
2. Children are supposed to become more cognizant of abusive situations and potential abusers. In most currently-existing programs, children are also made aware that not only strangers but also those familiar to them, relatives, and other trusted persons also sexually abuse children.
3. All programs try to encourage children to be proactive in the case of an assault. Simply put children are, first and foremost, encouraged to exhibit the three behaviors of say no, run and tell. Particular emphasis is placed on the importance of telling someone they trust about the attack. (See Conte et al. 1986; Finkelhor 1986; Wurtele 1987.)
The various prevention programs attempt to explain and characterize the above content in different overall contexts and in different ways. Almost all try to warn children about sexual abuse without actually educating them about sexuality. We will go into the problems inherent in such an approach a bit later on. A primary example of this, discussed below, is the "Child Assault Prevention Project", one of the most popular and widely-used prevention programs in the United States.
The "Child Assault Prevention Project" (CAPP)
The CAP-Project, which is based on feminist theory, uses publicity to bring attention to the subject of child sexual abuse. It also strives to break through children's social isolation and powerlessness. Therefore, within the framework of workshops for children, they are educated about their rights. They are told they have a right to be "safe, strong, and free," as well as to decide for themselves when it comes to their body and its private areas, which includes not being touched in ways that are unpleasant for them. (Cooper et al. 1983; Finkelhor 1986)
These rights, as well as the possibility of their being violated, are made tangible for children via short role-playing exercises. To begin with, a scene in which an older child tries to extort money from a younger child is depicted. In the next role-play, a stranger tries to persuade a child at a playground to come with him. In a third sketch, "Uncle Harry" might force his niece to give him a kiss, and then try to persuade her to keep it a secret.
 The CAPP facilitators would initially present "unsuccessful" versions of these sketches to the children, meaning that the child was not able to defend him/herself against the attack. Following each role-play the group, including the children, would consider what might have helped the child in each scenario. With the active support and participation of the children in
the class the same role-playing exercises would then be acted out several times with positive outcomes (the child finds a way out of the situation, defends him/herself, gets help from others). Then, in smaller discussion groups, the children were encouraged to help one another or seek assistance from adults.
The CAP-Project also offers self-defense strategies; these, however, cannot be regarded as being typical of existing prevention programs. (See Finkelhor 1986; Wurtele 1987.) Among other things, the children practice the "safety yell," an as-loud-as-possible scream "from deep in the belly." In cases where there is a risk of becoming a victim, the children are encouraged to jab the potential perpetrator in the chest area with their elbow, kick them between the legs, bite, etc. Yelling "No!" as loudly and as forcefully as possible is also practiced with the children in the class. The children are encouraged to trust their intuition and feelings, and not let anything strange happen to them. They should not, in this program, be enfeebled by rules, prohibitions, and panic-making, but rather, encouraged through an emphasis on their strengths, action-potential, and rights, and be equipped with greater self-confidence. To children, CAP is fun and exciting. It's not frightening or confusing. We teach children that they have the right to be safe, strong, and free. (Cooper et al. 1983: 3) We shall now go into the limits and dangers of such concepts.
Implementation of the Prevention Program
As a rule, the core of school-based prevention programs consists of working with the children in so-called child workshops. The amount of time required to complete them varies greatly. Whereas the above-described CAPP workshops take about an hour, other programs are purportedly of shorter or even much longer duration. (See Finkelhor 1986; Nelson and Clark 1986.) In addition to the child workshop there is usually also a one-time, perhaps one-to-two hour informational meeting for the parents of participating children. Here, along with a presentation of the contents of the child workshop as well as the provision of general information about sexual abuse, permission is also sought from the parents for the children to participate in the program.
The extent of special training received by would-be facilitators varies greatly from program to program. Some curricula just leave the carrying-out of the workshop to the school principal. Other programs provide the school with specialized outside trainers. Whereas some programs (i.e., CAPP) offer multiple-day training for prospective facilitators, and the programs are also carried out exclusively by persons who have undergone such training, other prevention materials can be used by completely  untrained "trainers," or the suggested preparation might merely be reading a book. (See Conte et al. 1986; Plummer 1984.)
The Association with Sexuality
A central question that all sexual abuse prevention programs must come to grips with is how frankly sexuality and the concepts and experiences associated with it should -- and can -- be addressed. Finkelhor (1986) talks about three basic problems that a prevention program must overcome in order to be able to gain entry into public institutions, i.e., schools:
- The subject of sexual abuse has to be presented in a way that children can understand.
- The aura of alarm surrounding the topic would have to be toned down, so as not to exacerbate children's insecurities about it.
- To the extent possible, a consensus should be forged among all of the adults participating in the prevention effort; that is, parents, teachers, and school officials.
In schools, where sexuality is rarely permitted to be discussed, programs which address sexuality in frank terms have little chance of being incorporated into the curriculum. Most prevention programs get around these problems by, insofar as possible, closing off any discussion of the subject of "sex," and avoiding language that could be used to talk about sexual experiences. Even in the titles of these programs, the explicit term "sexual abuse" appears only rarely. Instead the talk is of safety and self-help, or of assault prevention. In many programs the sex organs or genitals are not explicitly named. In its place conversation is about private zones, places usually covered by a bathing suit, and, corresponding to the concept of sexual abuse, about touching in private areas, touching allover, or touching under the panties. About this Finkelhor (1986) writes that such "tactful" avoidance of the subject of sexuality is generally well-received by all concerned. Parents and school staff, who often look at the prevention programs initially with a certain unease, would be appeased as soon as they had become convinced of the program's evident banality; that is, of its tabooization of sexuality.
A systematic analysis by Tharinger et al. (1986) of the language and content of 46 prevention programs for children and youth demonstrated that a large proportion of programs designed for children provide vague descriptions of what children are supposed to be protected against. Almost half of the programs examined do not give any explanation or definition of the term "sexual abuse." The definitions found in the remaining programs do not, for the most part, contain any concepts relating to sexuality. About two-thirds of the prevention curricula never correctly named parts of the body and genitals.
 On the Effectiveness of School Prevention Programs
Although various studies measuring the effectiveness of school programs have been carried out in which the participating children’s learning results have been clearly emphasized, the meaning and importance of the measured learning results must be thoroughly and methodically examined. (See Reppucci and Haugaard 1989; Wehnert 1990; Wurtele 1987.)
It is true that the majority of effectiveness studies do permit a conclusion that children who were informed in a prevention program about the existence and meaning of sexual abuse have a greater knowledge about it than they did prior to completion of the program, or compared to an untrained control group. Prevention programs' possible influence on children's actual behavior, however, had rarely, if ever, been assessed. Oral or written questioning can, however, only assess knowledge learned about ways to behave, not its translation into real action. Many prevention programs and effectiveness studies do make an attempt to measure effectiveness using simulated "potential abuse situations." (See, i.e., Fryer et al. 1987; Miltenberger and Thiesse-Duffy 1998.) In the test situation, such "potential abuse situations" are reduced to a "stranger" speaking to a child and asking him or her to come with him. Moreover the child's consenting to this is evaluated as an unsuccessful test/prevention program, whereas his/her refusal is deemed to constitute success. Such simulations, however, suffer from a completely unrealistic view of potential abuse situations and their possible avoidance because there are no references to sexually-tinged approaches and abuse by people who are close to them. Therefore the changes assessed in role-playing and simulations involving interactions with strangers should be regarded with great caution, because they say little or nothing about how these same children would behave in real sexual abuse situations involving people they trust and/or love.
Whereas it is difficult to predict children's behavior following a training program, knowledge about the subject of sexual abuse acquired by children in such programs can be readily measured. Children from about age six on seem more able to cognitively absorb oral or written information than younger children.
Only a few studies of the emotional effects of such programs exist, and have, moreover, arrived at some quite different results. Furthermore there needs to be a discussion about whether children behaving more cautiously or skeptically towards persons who are unfamiliar -- or familiar -- to them is to be regarded as a desirable -- or undesirable -- effect of prevention programs.
Current child sexual abuse prevention programs are ripe for critique; along with some aspects regarding content, we would like to expound on this in the following. We will also consider the types of -- and ways in which -- the programs are implemented.
Very frequently, one finds a simplified depiction of non-abusive and abusive behaviors as good touch, confusing touch, and bad touch. However, the original idea behind this concept, of a continuum of various kinds and sorts of touching and the feelings associated with them, got simplified in most prevention programs. The discussion, then, is still only of ok or not-ok-touching, of red-flag-touch or green-flag-touch, of touches that elicit either a yes or a no-feeling, good, or bad.
Finkelhor (1986) sees a risk for misunderstanding in this sort of simplification, because at least at the time, i.e., the beginning of an abusive relationship, the sexual abuse could also elicit positive feelings within the child. Under certain circumstances, the attention and gifts that are also part of the abusive situation can lead to good feelings on the child's part. An additional problem in addressing sexual abuse in the simplified bad touch formula, noted by Wurtele (1987), is that there are also forms of sexual abuse which don't involve actual touching at all (i.e., pornographic activities or masturbating in front of the child). Moreover such a simplified terminology leaves open the question of whether it is the child's feelings or the acts of the adult that are to be regarded as good or bad.
In addition, these prevention programs fail to consider the fact that child sexuality is different from adult sexuality. As early as 1933, Ferenczi characterized adult sexual encroachments upon children as "linguistic confusion," which was, moreover, related to the developmentally-dependent divergence between child and adult sexual desires and fantasies. Prevention efforts should also include learning about the workings of their own bodies, within a framework of child sexuality. Here it is important that children be provided, by those responsible for their upbringing and education, both the room to develop as well as boundaries. This will serve as the foundation of a partnership-oriented sexuality in adulthood.
Based on insights gleaned from Piaget's theory of development, DeYoung (1988) does not believe that children up to age seven or so would be able to grasp the good touch/bad touch principle. Because, due to their developmental status, younger children would not be in a position to recognize or decode the ambiguities inherent in an abuse situation or foresee its recurrence, the comprehensibility principle means that this is not one of the target groups of current prevention programs; if it were, we could expect only the most limited results.
 Avoiding a Frank Discussion of Sexuality
Correct anatomical terms and clear, sexuality-related concepts are seldom components of these programs, to say nothing of the experiences, feelings, and fantasies through which children have a connection to sexuality. This avoidance reflects the fact that prevention programs were adapted from those used in the United States, where the prevailing norm in many places is that sexuality is not supposed to be discussed, at least not explicitly, especially with children. Consequently, prevention programs that avoid talking about sexuality are making a compromise between a desire to work with children preventively in the area of sexual abuse, and the taboo against openly discussing sexuality. Even if making such a compromise might be understandable, we still have to ask what the consequences of curtailing sexuality, feelings, and fantasies are or could be.
Finkelhor (1986) questions whether children are really able to grasp what sexual abuse means when, for example, "Uncle Harry" is shown forcing his niece to give him a kiss. The difference between real sexual abuse and how it's presented in prevention programs becomes even starker when abuse is described as touching allover or as an uh-oh feeling. Furthermore many authors criticize the fact that in most prevention programs, children are not provided with an adequate vocabulary for talking about sexuality, their own bodies, and perhaps even abuse experiences. The double-message conveyed by the avoidance of frank and clear language about sexuality is described by Anderson (1986:21) as follows: "What we are saying is, you can tell me about sexual abuse, it's not your fault, there's nothing wrong with you. But your body is so bad that I can't even say what's underneath your swimming suit." When feelings are explored without the use of proper terms like penis, vagina, and breast, adult anxieties about their own physicality and sexuality, combined with conversations about abusive and offensive behavior, are implicitly passed on to children. Even the expression, “the body isn't bad,'” would scarcely be of help to a child tormented by guilt and fear.
In repudiating clear language about sexuality there is a risk of the explicit message of the prevention program being overshadowed by its implicit message, that sexuality just isn't supposed to be openly discussed. Finkelhor (1986), moreover, criticizes prevention programs' depiction of sexuality. The exclusive emphasis on avoiding negative forms of sexual contact could leave children with the impression that sexuality is a pretty negative thing in the first place. Therefore he pleads for a closer connection between prevention programs and sex education. Children will not be able to obtain adequate information about sexual abuse in a climate that does not allow adults to really talk about sexuality with children. Changing this climate can only come about through better sex education.
 The simplified and sexually-avoidant ways in which sexual abuse is frequently depicted in prevention programs has the effect not of putting sexual abuse in the context of sexuality, violence, or the abuse of power, but rather of reducing it to a vague feeling uh-oh feeling or to a phrase that doesn't exist in general usage, red-flag-touch. Consequently sexual abuse becomes something ineffable, something that, especially where children are concerned, can only be hinted at. It would appear that the prohibition on discussion and heightened anxiety that are integral to the experience of sexual abuse are actually carried into the programs themselves.
A study of the effectiveness of parents' workshops from seven extant programs (Berrick 1988) came to the conclusion that, in addition to a lack of interest on the parents' part in this (voluntary) event, very little actual learning took place in terms of knowledge, attitudes, and consideration of possible action. In light of these results, the authors recommend a re-examination of the concepts and approaches of such parents' workshops.
As with the workshops for parents, the prevention programs' facilitator training sessions -- i.e., for teachers -- are not, as a rule, the programs' primary component. There is also a risk here of hindering the real discussion that could lead to understanding and properly treating the complex subject of sexual abuse, and with it, responsible prevention. The consequences that an improperly implemented prevention program could have for children are, according to Conte et al. (1986), hard to estimate.
In connection with this, the possibility should also be pointed out that while participating in a prevention program, children as well as adults may reveal current or past abuse situations. Prevention program facilitators must be prepared for this, and at the same time be aware of their own potentialities and limitations in dealing with such situations.
The general question raised here is whether programs which, like those frequently administered in the United States, are dutifully carried out by educators, and which have not -- or not of their own accord -- grappled with the problematic nature of sexual abuse, are able to make a meaningful contribution in terms of information and prevention. Here the dynamics of sexual abuse also seem to have an effect on the implementation practices themselves, whereby at least some educators are pushed by the powers-that-be into conducting such programs, which is asking too much of them. Therefore such coerced prevention work must in all cases be repudiated.
 The Concept of "Empowerment"
Another fundamental issue that needs to be examined is the idea of strengthening and encouraging children to thwart sexual abuse, as in the earlier-described CAPP example. According to a study by Tharinger et al. (1988), this so-called empowerment concept underlies approximately 60% of extant prevention materials. The remaining programs examined by Tharinger et al. (1988) were based on developmental or learning theories to only a vanishingly small degree; predominantly, however, there were no detectable foundational concepts at all.
The term "empowerment" originally came from the women's movement. In prevention programs for children, it finds expression in the basic messages given to children of "Your body belongs to you," "Trust your feelings, your intuition," and "defend yourself, say no." In order for these basic messages to be absorbed, however, a child has to have the experience of being an autonomous person, whose independent affairs are protected in dangerous situations. This prerequisite, however, is exactly what most children from incestuous families are lacking; but this is also true with so-called latently-incestuous families, in which, though it is true that direct sexual assaults do not take place, there is nevertheless an atmosphere of denial and diffusion (see Braun-Scharm and Frank 1989). Only children who experience themselves as being independent and feel accepted will see their bodies as their own and not as the possessions of other persons. Trusting their own feelings is only possible if differentiated feelings (like, dislike, etc.) are actually able to be developed, and the child has also learned to perceive and communicate them. Only children who do not have an all-too-great fear of possible punishment for turning down a requested activity will trust themselves, in an emotional and therefore serious situation like sexual abuse, to resist or
The danger in the basic idea of empowerment lies in the fact that responsibility for the abuse would be shifted to children who could not or would not be able to defend themselves in an abuse situation. Trudell and Whatley (1988) write of this problem, characterized in U.S./American specialized literature as blaming the victim. On both the individual as well as societal level, the responsibility for sexual abuse and its prevention should be seen as resting on adults, not children.
Though only encountered in a few prevention programs, self-defense training for children is still worth mentioning because it represents the principle of empowerment carried to an extreme. What we have here is the clearest illustration of an illusory desire to make the child as strong as -- or even stronger than -- the perpetrator. It would appear to be not only asking too much but actually downright dangerous and absurd to expect children in a one-hour program (i.e., CAPP), in addition to various role-playing exercises and receiving information about "rights," to also be able to grasp the fundamentals of self-defense. With such training, attention is diverted from -- the substantially more common -- abuse within familial and friendly circles, to the stranger perpetrator.
 In conclusion, regarding the vast majority of prevention programs from the United States to date, it may be said that the dangers addressed and suggestions made in these programs simply do not make sense. The prevention programs' ostensible goal, preventing child sexual abuse by strengthening the defenses of potential victims themselves, seems unrealistic. The behaviors that children are supposed to learn in order to thwart sexual abuse (saying no, running away, telling someone) ignore the fact that sexual abuse is committed predominantly by persons who are close to the child and are therefore embedded in a context of nearness and trust, where talking about it is forbidden. First of all, children who have already become victims of sexual abuse could be subject to additional pressure in that they are now supposed to resist as well as report such experiences, when this is just not possible. Moreover the issue of individual psychosexual development, first and foremost regarding the parent-child relationship, is not considered at all.
The declared successes of prevention programs cannot, by any means, be seen as proven. Undoubtedly, in some programs an increase in children's knowledge could be established. Notwithstanding the sometimes questionable methods by which this increase is measured, we nevertheless must ascertain what knowledge will protect children, and what will render them more insecure. Rarely, if ever, is it possible to ascertain that there has been an influence on how children act in situations where they are obliged to engage in sexual acts by relatives or other persons familiar to them. And results of studies looking into how children behave around strangers would not appear to translate to the real world.
One of the dangers of these prevention programs is that children, parents, and other adults concerned about the subject may get the idea that the implementation of such programs will be able to effectively prevent child sexual abuse. In this way, further additional investigation into the causes of sexual abuse of children and others -- i.e., secondary ones -- would be hampered by prevention efforts. Public efforts, via a fundamental overhaul of such programs' parent, teacher, and child workshops, should aim to provide a realistic picture of child sexual abuse, as well as bring attention to avenues of assistance for children and adults who have become victims of sexual abuse. This is, however, conceivable only if the implementation of such a program provides the potential for explaining in detail the various aspects of child sexual abuse, above all their own feelings, but also to get professional help to those with relevant experiences. Moreover it would seem sensible to explain to children the danger of sexual abuse only if it is embedded within a sexual education that allows for sexuality to be spoken of in clear terms, and permits feelings and fantasies to be named. Otherwise there is too great a danger they will be warned of unarticulated things, thereby evoking -- instead of enlightenment -- insecurity, confusion, and guilt.
 Concluding Remarks
At this point in time, the above-described and critiqued school prevention programs are, it is true, distributed mainly throughout the United States. Meanwhile, however, there have been demands that such programs also be implemented in German public schools. Even CAPP is a program that has become increasingly familiar to -- as well as popular among -- people here. (See Fegert 1987; Fey 1988) However, the wholesale adoption of these programs for use in Germany is by no means to be recommended. It seems that what is needed instead is a fundamental re-thinking of the whole approach to prevention. Most welcome are initiatives for preventive work with parents (see Mitzleff 1989), that is, efforts in which adult ~en and women are asked, for example, to prevent the perpetration or facilitation of sexual abuse. Parents, educators, and adult society in general should not use prevention programs for children to soothe themselves and avoid responsibility. Rather, we must come to grips with the fact that everyday upbringing and education in obedience, adaptation to patriarchal gender roles, the suppression of sexuality, and the inhibition of feelings provide the social -- as well as individual -- breeding ground for sexual abuse.
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Natascha Wehnert-Franke, Ph.D., Adjunct Prof. Dr. Hertha Richter-Appelt, Christine Gaenslen-Jordan, Ph.D., Department of Sex Research, University Psychiatric and Neurological Clinic, Martinstr. 52, 2000 Hamburg 20, Germany