When the Help You Seek is for Yourself

Teresa Huizar: Hi, I’m Teresa Huizar, your host of One in Ten. In today’s episode, “When the Help You Seek is for Yourself,” I speak with Dr. Melissa Bright, founder and executive director of the Center for Violence Prevention Research. Now, if you’ve listened to One in Ten at all, you know that one of the topics that we’ve come back to again and again has been problematic sexual behavior in youth.

We’ve talked about what contributes to it, what effective treatments exist, and how to work with families. But what can we do to prevent it in the first place, and how do we interrupt any at-risk thoughts before they become at-risk behaviors, as you’ll hear the What’s Okay Helpline is an effort to do just that.

And what is so very hopeful about these efforts and the research that examines it, is that so many young people are seeking help on their own and are eager to get that help. What does all of this mean for child sexual abuse prevention efforts and how do we help teens who are worried about harming others to get the intervention and support they need to lead safe and healthy lives?

I know you’ll find this conversation as fascinating as I did. Please take a listen.

Hi, Melissa, welcome to One in Ten.

Melissa Bright: Hi. Thank you for having me.

TH: So, I’m curious, how did you come to this work researching youth with problematic sexual behaviors and in this case the study that we’re gonna talk about today? The What’s Okay Helpline?

MB: So, let’s see, how did I come to this? I think it came from a partnership with the creator of the What’s Okay helpline, Jenny Coleman at Stop It Now.

And I have always been fascinated by this idea of a helpline for people who have or think they might cause sexual harm. And back in 2021, Jenny said that her team was going to create a version for youth, and would I be available and interested in doing some research around it early on was process work, you know, would people come and then maybe eventually we would do some evaluation outcome stuff.

And I said I would absolutely love to do that, Jenny, but I think it’s crazy that you think youth are going to contact you and tell you that they have or might cause sexual harm and more importantly that they wanna stop or prevent or do anything about it.

But sure, you can pay me to take a look at the data that I don’t think will exist. And sure enough, they sure did call, I mean, I say call. They didn’t call. They emailed and texted and chatted. Yes. And they have been unable to even meet capacity for a long time because the demand is so high for such a service.

So it’s been fascinating from a service perspective to see the need for such a thing. But then from a research perspective, there’s just mounds and mounds of data from all angles that we can look at that allows us to understand these youth better and help Jenny’s team and other teams around the world fine tune services for them.

TH: So many of our listeners will not know what we’re talking about when we talk about the What’s Okay Helpline, even though we’ll link to your article or articles in the show notes. So can you just in a nutshell, what is it that we’re talking about?

MB: The What’s, okay. Helpline is a resource center, so it is a website Whatsokay.org, and it’s a helpline. The helpline is not 24 hours. It’s somewhere between 30 and 40 hours a week, I think. And on the other end are helpline consultants who are trained in problematic sexual behavior, a little bit of crisis management, but also motivational interviewing, strength-based counseling, and anyone, but it’s targeted to youth, can reach out to the helpline via email, text chat, or phone call or snail mail letter if they really want to, and reach one of those consultants to ask questions about anything related to sexual behavior, interest, feelings, et cetera. And that is very vague, but Jenny’s team does a phenomenal job of crafting their messaging so that their target audience really is who gets to them. And so it’s primarily questions around boundary crossing and has someone crossed a boundary with me or have I crossed a boundary with them?

Or causing sexual harm. So I think I might have done something when I was younger with my cousin or my brother or a neighbor, and the helpline is free and confidential. And there’s really no parameters on how long you can talk or how many questions you can ask. It’s not a hotline where someone might call in and just wanna get referred to our local resource.

It’s a helpline. So they really do provide, what I like to think is the intermediary between crisis help and therapeutic support. It’s that middle ground, and they do provide a lot of resources and referrals to resources on their website, but also a lot of other websites and services that people can access.

TH: Well, if I’m remembering right, the consultants are licensed clinicians, right? Or licensed clinical social workers or something. So in other words, these aren’t just random volunteers or consultants in a general sort, you know, they have a clinical background.

MB: Correct. So some of them are licensed clinicians.

They’re not volunteers, they’re all paid staff. So they go through a pretty extensive training and in addition to just the general training that’s required, I think for operating a helpline of any sort this is a very niche topic and so they get quite a bit of training on addressing this particular topic and the type of questions they might be fielding, and also self-care and acknowledging secondary trauma and how to take care of themselves when dealing with such a heavy topic.

TH: So let’s talk a little bit about how it’s advertised. How do people find it? And also who’s calling? Like what ages, what are their demographics? What do we know about this population that is not actually calling? But as we’ve been talking, it’s hard not to fall into that calling because we think like something line, it has to be on the phone.

But as you say, emailing, chatting, whatever it is.

MB: I try and remember to say contacting, not calling, but it’s default to say calling. So how do they find us? This is a great question. Like I said, I’ve been with the What’s Okay team since the very beginning, and our answer to this question is changing as we get more information.

So before anyone knew about What’s Okay. The plan was to put out social media advertisements, and we know that a lot of young people use social media. I think we had done some research that it was well over 90% use social media daily, or almost often throughout the day. But then more importantly, that’s where young people said they go for their health information and for advice that they would trust medical information. So we wanted to serve them with helpful and accurate information in that way. So. There was a communications manager with the What’s Okay Team that developed these beautiful advertisements that were put out on several platforms, and then she did all sorts of magic that communications people do to figure out which one works best and what platforms and which ads and all of that. And then more focus was put onto the ads that were doing the best and where they were getting the most, and they’re very successful. So ads are measured by impressions. So how many times are they seen? And then also engagement. So how many clicks that they get.

And the clicks would take people to the website. And I think to date, those advertisements I think are over 8 million impressions. And the clicks, gosh, I don’t know, but certainly in the hundreds of thousands. And so they’re very effective and they have great metrics compared to other advertisements on those types of platforms.

We are learning now, I think as the service has been more well established and we’ve been talking about it at conferences and professional societies, it’s emerging higher in organic searches online. So some of the young people have been looking for a while for resources and have been asking this question for a while.

So they might have asked it and ended up in a Reddit thread or some other online discussion board, and now the top search is coming up with whatsokay.org, and so they’re being directed to that. So a lot more of the actual helpline inquiries are coming from organic searches and the website traffic is coming from those social media advertisements, so we’re able to hit both sides.

And then a secondary approach that the What’s Okay team is taking is making sure that all the professionals who work with young people who might benefit from the service know about it. And that’s obviously difficult ’cause there are millions of those professionals nationally and internationally. But distributing information to school counselors, school nurses to public libraries, to anyone who might interact with a young person, but that’s obviously slower than the social media where everyone is on it all the time and can get immediate gratification for an advertisement.

TH: What are the ages of the folks who are calling? Are these tweens? Are these teens? Are these young adults? Like who’s reaching out?

MB: So the target audience was 14 to 21, and that was somewhat on purpose and somewhat arbitrary, at least the cutoff at 21. Less than 14 felt, hopefully I’m saying this accurately and if not, Jenny, you’ll come back and correct me, but maybe not appropriate to have those conversations with them directly.

Whereas 14 was kind of a, again, arbitrary cutoff of this is a person making their own decisions and seeking their own information online and they could help them. And then 21. They conceptualize that anyone over that really might be closer into the adult development realm, and they would direct them to Stop it Now, which is the equivalent service, but just for adults.

So 14 to 21 is the target. And that has been who contacts most are actually, I think under 18, last I checked, I think 16, 17 was the most common age, but certainly a large share are the 14 to 17 on the younger end of that, and then actually even above 21 sometimes as well. We get parents or teachers or someone calling about a child that they know that wants their questions answered.

But as far as the young people, it is primarily under 18 and that 14 to 17 group.

TH: So in your paper you broke down the reasons that people called, and I’m curious before we get into what you found, what were you expect? Well, first of all, you were expecting nobody was gonna call but, or email or text or anything.

But once it moved past that and you were into the data and you could see that folks were reaching out about things, did you think that most people who reached out had a question about their child, someone in their family, that sort of thing, or did you think it would be folks who were actually worried about their own behavior?

I’m just curious about what you thought you would find and what you actually did find about what folks were doing and why they were calling.

MB: So those are actually different answers and, probably again, Jenny’s team thought they would find what actually happened ’cause they’ve been immersed in this world for a long time and they’ve seen evidence that people will reach out for help before causing harm.

But me not knowing that, I thought that we might get youth who are survivors who are seeking survivor support or victim services connections that we might get parents who are calling about their very young children who are actually engaging in very healthy development behaviors, but they’re concerned ’cause they’re not sure if their child is on the path to danger or that if they are doing something inappropriate.

So those were kind of the big buckets that I thought we might get. I thought people might contact, especially youth in more of a pranking fashion that they might contact to say, oh, I’m doing this or I’m doing that. Ha ha ha. I don’t know why I thought they would do that. I just think if you let youth run wild on the internet, who knows what you’ll get.

And that’s kind of the audience we were reaching out to. But what we actually found is. The most thoughtful, well-articulated, concerned young people who have deep concern for some issues that are very problematic, but others that are not and are just healthy sexual development, but they’re worried about crossing boundaries with someone.

I remember one of the very early inquiries that I read was just a young person, I don’t even know their gender, but they said how many times is too many times to masturbate per day? And so that was just a healthy sexual development question that they had. And then I think the very next person that contacted was used to sleep with my brother in the same bed when we were younger. And I think I might have touched him inappropriately, but I don’t wanna bring it up because if he doesn’t remember, I don’t wanna traumatize him. But if he does remember, I wanna apologize. And I feel very guilty about what I might have done.

And this was a 15 or 16-year-old and they had deep concern, again, guilt, and they had thought about the repercussions of bringing it up or not bringing it up. And they were seeking help for someone to help practice. And then everything after that has really been very similar to those. And there are some youth that inquire about having a sexual attraction to children.

And they are deeply concerned that they will hurt someone, that they haven’t actually done it yet, that they avoid children, that they don’t want to interact with them, that they can think of nothing worse on this earth than to hurt a child. And so they seek a lot of reassurance if they are doomed or if they are going to turn into this quote “monster” that they think that they are or will be, or how do they talk to a therapist, find a therapist, get support, and try and navigate that process of healing and not causing harm.

TH: As you were talking, I was thinking about the fact that for these young people, it has to be, of course, they’d be concerned anyway if they were having feelings that they might harm someone else, but because the sort of stories that they hear in the media, and what you see in film and in movies and on TV about people who do cause sexual harm, you can only imagine the way that would additionally weigh on them and probably is a tremendous motivator actually in their determination to reach out and try to get some help. But that’s a big burden to carry around when you’re 14, 15, 16.

MB: Absolutely. A big burden that they want help for, but the people that normally help them, even the people that would normally help them, their parents, teachers, et cetera, these youth know that those people might be very disgusted or scared or turn away because it’s such a difficult topic and certainly it’s difficult, you know?

And so they are carrying the weight of something that they understandably know other people are going to shy away from and might not be supportive, might not understand that they actually want help and that they’re not trying to cause harm. So a lot of the questions are actually of the youth who think they might cause harm.

How do I talk to my parents? How do I find help with this? How do I get to a therapist if I’m a minor and I don’t have my own health insurance or a car or any of that, how do I do it? And the helpline consultants are excellent at navigating that with them and giving them advice on, you don’t have to say exactly why you want a therapist, but just say, I’m struggling with some issues, that I would like to talk to a counselor and see if your parents would help you navigate that or finding other strengths and supports in your network. If it’s not your exact mom or dad, is there someone else in your life that you can talk to and trust and help you as you get formal supports and more long term.

TH: One of the things that I noticed in the study that I read was that of those who called more than half either had harmed or were concerned that they might harm someone, and it was interesting to me that it was pretty evenly divided.

Once you looked at that, I don’t know, 52% or 54%, whatever it was, it was pretty evenly divided between the two. So for even those youth that had acted out, and I think this is a very positive thing, that even if they had already taken an action, they were concerned about it. You know, it wasn’t like they were dismissing it, it was driving them to reach out for help.

MB: Absolutely. I 100% agree. And that’s the audience I thought. There’s no way these people are contacting. Why would anyone contact a helpline to tell on themselves even though it’s confidential and we’re not sharing their information and you know, all of those things. I don’t know that they would. Ever a hundred percent believe that, but that risk is worth it to them because they either, again, feel guilty for what they’ve done or they’re unsure if they actually did cause harm, or was it something that is normal for children to do if they were a child when they did it, or they very much want to find help for the person that they harmed that outweighs the risk of getting in trouble or being this bad person that has done something.

TH: I mean, having empathy and a conscience or essential human qualities, I think that bodes well, you know, in terms of managing the behaviors that have happened, having effective treatment, responding to that treatment so that it’s not something that this young person has to be concerned about will carry on into their adulthood.

Because I think that one of the things that youth with problematic sexual behaviors can see for themselves is that their life trajectory, if they were to continue that behavior is not good, right? You know, there’s no positive outcome in terms of your relationship with your family. There’s no positive outcome in terms of the kinds of friendships you’ll have.

From a legal standpoint, there’s no positive outcome. So I think that it’s an interesting thing to me, the way in which these kids are weighing these things up and have some long-term thinking and maybe longer term than we’d give them credit for about, you know, wanting to stop something now as this, as the name of the program suggests, before this becomes something that’s more like identity essentially instead of something that someone did or a mistake somebody made one time.

MB: Yeah, you’re absolutely right and there’s always the individuals, whether it be young people or adults who have caused harm and are okay with it or fine with that identity, are not gonna contact the helpline.

We’re never gonna hear from them. So I don’t know what portion of those who cause harm that is, well, I, we do know from some other research that it’s a very small portion. It’s like 20% or something of those who cause sexual harm, but most of them really don’t wanna do it. Or are greatly, again, remorseful when they’ve done it or they did it on accident, or I don’t wanna take away responsibility, but unintentionally, perhaps they did it without realizing consequences or realizing what they were doing.

And yes, they identified the trajectory of their life if they continued down that path. But I think it’s even beyond that, that they don’t even want that path because they most of them are not attracted to children. It’s not something they feel like they want to do, it’s that they don’t know how they found themselves in that situation the first time, and they don’t want to be finding themselves there again.

TH: You know, as you were talking, I was thinking about how much of teen behavior could fall into that category of they not sure why they wound up in a situation that they shouldn’t have been in doing something they shouldn’t have done. It’s not just around sexual harm, it’s about all kinds of risk-taking behaviors, right?

Because, you know, kids just don’t have the same ability to process all of these things that we do. I’m just curious what. The reaction, not a professionals already working with these kids, because one would hope their reaction to this would be, thank goodness the helpline exists. Right? I can think of all kinds of kids that will benefit.

This is great. Let’s get the word out there, but I’m curious about other folks who may work with youth but not necessarily have a lot of exposure to youth with problematic sexual behaviors in youth, and I’m wondering what their reaction has been to your work, your studies. Are people just like, I cannot believe what I’m hearing or reading, or whatever, or are people very open and receptive?

MB: The former, for sure. I think my initial reaction is probably a very common one, and I was even on the optimistic end of. Yeah, right. No one’s gonna call and tell on themselves or implicate themselves in some harm they might do. Why would anyone do that? It’s like calling to say, I might drive drunk tonight.

People don’t do that or I don’t know. I just didn’t think that that was even a concept. And the people that I talked to, certainly outside of research and outside of child protection or child welfare, anything to do with that are just as shocked that this would even work. But I think it’s also been a great conversation starter about who causes child sexual abuse and what that dynamic looks like because so much of the general public opinion is still creepy predator monster man in the bushes at the park. And that absolutely is true sometimes. But if we only focus on that person, we’re going to miss a whole lot of sexual abuse.

And so we have to understand the much broader spectrum of people who cause harm and what those people look like, what the situations look like, the victims, the scenarios, the ages, if we’re gonna get our hands around this very complicated issue. So for me, it’s been a great conversation starter of, did you know that actually a lot of the sexual harm, if not most of it that we see is caused by adolescents?

It’s not adolescents who are perverted and just wanna do weird things that are your 1% of the population that end up on a Dateline special. Like it’s much more common than that because the issue is very nuanced and people are more receptive to that. I think it’s eye-opening and sometimes a little uncomfortable because then it feels like, oh, well I might know a kid like that, or that might be my neighbor.

But also reassuring because, oh, this isn’t this scary unknown person that I have to be constantly vigilant in the lookout at the park about that we have some misunderstanding of the full picture. And I think people can always rally behind a kid more than an adult. So it’s also been nice to work in the perpetration prevention space in, again, a setting where people are more open to discussing it as opposed to.

It’s really difficult to cultivate empathy for an adult who’s caused harm, and I get it. I personally couldn’t work in that research space, but it’s easier to think, okay, kids make mistakes and kids are malleable and developing and can change, and you intervene and we can change the trajectory of that kid’s life and all the other kids around them.

And people are, I think, much more open to that type of discussion.

TH: One of the things I was thinking about as you were talking is the degree to which this has all been influenced by the fact that kids are just exposed to abusive imagery. I mean, not seeking it out even just to like. The shocking availability of that kind of content online and the way that algorithms feed that up and the way that youth who are not even purposely trying to access it initially can wind up out of curiosity and a lot of other things being pretty dramatically exposed to it.

And I’m wondering. To what extent do you think that is driving any of the outreach to helplines? Because I think it’s, even if they are not saying that the reason that they’re reaching out is because they’ve had this exposure and they’re wondering about it, it just makes you wonder to what extent that that’s adding to the concern and the behavior ultimately.

MB: Yeah, I think you’re exactly right. And two thoughts come to mind. One, they are explicitly telling us that. So I mentioned the mountains and mountains of data that we have and I just wanna touch on those for a second to show you how we can answer those questions. But we have all of the transcripts of the helplines, so, the full narrative of the Inquirer and the consultant from beginning to end, everything that they’ve said, their questions. We then have a set of pre-questions before they get in about what’s their primary reason for contacting their gender identity, their age, all of that. Then we ask them a series of questions at the end about how was the contact, would they recommended it to a friend, all of that.

Then we’re in our study, we’re doing a longitudinal study. We ask them a whole host of questions about behaviors they’ve engaged in, their help seeking all of that, and we were following them for about six months. On top of that, we formed a research advisory board where we invited our participants to give us feedback on the research process.

So these are youth who have questions or concerns about their sexual behavior interest, we have kept it completely anonymous. And so we help them, although they already know how to set up sort of throwaway emails and phone numbers, and we send them individual questions as opposed to a group setting. And one of the questions that we’ve asked is:

What do you think we should research about this? And the repeated response we get is about the impact of social media. And they have said over and over again that social media is horrible and that they wish it didn’t exist. And it’s just such a mental burden for them. It’s a little ironic ’cause they found us via social media probably, and I don’t know that it’s going away, but they are absolutely acknowledging the challenges of navigating the influx of images and content all day, every day. And that’s where their social networks are now. They’re very much virtual, so I think they are aware of that. And then the other thing I wanted to touch on about the imagery is , a not insignificant amount of the inquiries are youth who say they accidentally think they may have seen CSAM or child sexual abuse material that they were looking at pornography and either the algorithm fed to them or they were on an adult site that then this other thing popped up and they’re traumatized by it and they’re like, oh my gosh, I can’t believe it.

What happened? And so they one, they’re very upset that they saw the image, but then they’re also now concerned did they break a law? Are they now culpable of something that they need to tell somebody about? Or what, how do they disclose that they accidentally saw it without being arrested themselves?

And they have a lot of questions around that and questions around. You know, my friend sent me this thing, or it’s been going around my school, and then I learned you can’t share images of kids under 18 and my friend’s under 18. So what am I supposed to do with this now? It’s on my phone. Or it was on my phone.

I think that it is explaining this nuanced concept a lot more. That very early days of our research of CSA were conceptualizing it as certainly an adult and a child, and maybe even initially focusing on familial cases because that was perhaps the most egregious form that would sort of spark our interest in, we wanted to figure out why people would do this. And then as the more we understand about the topic, the better we can get at preventing it. So now that we know more of the dynamics of, again, where it’s happening and with whom it’s happening and what’s driving it, and how much of it is intentional versus situational, that’s a big deal when we design a prevention strategy.

And how much of it could be prevented with a little bit of prevention education or resources or policies, like how much can we move that needle? So to me, just understanding the whole dynamic is a huge win for designing prevention services, and as we’ve alluded to a few times, again, I have no shortage of data to hopefully get that story out in as many ways as quickly as we can write it and analyze it, it’s getting out from all sides of it of like, what are they saying? What are they asking? What are they doing afterwards if they’re just contacting the helpline because they’re scared in the moment, but then two weeks later they don’t care anymore, or, which I don’t think is the case actually, but what is that window of opportunity where they’re help seeking and how can we connect them to the right people?

I think it’s also illuminating or hopefully, shining a light on the importance of perpetration prevention and not just focusing on potential victims and survivors. And there is another half of the dyad that we can address. And it doesn’t mean we should only do that. I don’t think we should only be focusing on potential victim education and prevention.

But it’s a very powerful piece, I think. And I think if people believe that those who cause sexual harm don’t want to or can’t be stopped, changed, what have you. After we get over that assumption hurdle, then I think there’s a whole field of prevention open to us that we can start to be addressing and make really big changes in.

TH: For some people, that’s a very large mental hurdle you’re describing, and I’m curious about what you have found to be successful when dealing with the general public in lowering that hurdle. Because I think professionals, I mean, we have some experience over many years of educating multidisciplinary team partners and others about these things.

The general public, I think, in our experience is a little trickier to convince them. That what applies to adults doesn’t apply to children and that it’s not monolithic and all the things. So what are you finding helpful?

MB: To me, it goes against my methodology as a scientist to be very numbers heavy. But the great strength, or one of the many great strengths of this project and this collaboration with what’s okay, is the stories that I’ve seen in these narratives where I can tell people.

Look, I was you. I did not think anyone would contact before they harm someone. But I’ve read these stories. I have read what these young people are saying and the very specific questions they’re asking of, how do I not do this? How do I talk to this person and how do I get help without hurting someone else, without making this a bigger problem than maybe it is.

And so those have made me a believer for sure. And stories I think are very powerful as examples to be able to illustrate this is what it looks like in real life and bringing to light these cases that I think are representative of a lot of cases across the world are helpful to show people that this is what it looks like as opposed to this concept that we’ve been working with for so long of, again, these older adult male monsters and that that’s the only type of perpetrator, which we know it’s not.

TH: I think there’s something very hopeful in this research. I think there’s something very hopeful in the helpline and the fact that there are kids who are reaching out and saying, I need help. You know, I want this to stop right now. And I think that it’s for us as adults, you know, to turn that hope into some kind of action that benefits all kids.

And just really appreciate your research and your partnership with Stop It Now and what that is really meaning for these youth. What else should I have asked you and didn’t, or what else did you wanna make sure that we cover today?

MB: Oh gosh. I could talk about this project all day, every day, and just the uniqueness of the service and then what it’s opened up for my researcher brain of all of the different types of data that we have, and again, we will be producing it as much as we can get it analyzed and get it out there and what we’re learning.

I am most proud of our advisory board of youth because, one, I’m proud that we were able to cultivate such a sensitive group and get their trust that they are willing to engage with us regularly. Knowing that the reason they’re a part of this group is that they most likely have caused harm or might cause harm in the future, and that they are at least at risk for it, but that they are so committed to research and the process, and they’ve said many times that they do it because they don’t want anyone else to feel like this or they don’t want any child to be harmed.

And so the information that they are providing us is so novel and helpful, and we ask them directly, what do you want researchers to know and what do you think we should study about this? Or what are the challenges to doing research with a group like you? And they’ve given us all their answers. And again, they’re just so thoughtful.

It makes me so hopeful for the general world of the, this being the next generation of leaders and adults and this topic that they are seeking help and they do wanna engage and that they are committed to this as much as we are. So that satisfies my nerdy brain and my just general citizen mom brain that it, you know, I feel better about where we’re going.

TH: Melissa, on that note, let me just thank you for being here, sharing this really essential research about an essential service, I think, and come back anytime. I know you’re digging deep into the next wave of data, and so when you have another publication that you’d like to talk about, we have an open door here.

Thank you for your work.

MB: Thank you so much and thank you for this platform and opportunity. To share it widely. Again, I encourage everyone to go into the website, check it out, and our article will be linked, and I again, could talk all day every day about this. So if anyone wants to talk more, happy to do it.

TH: Thanks for listening to One in 10. If you know somebody who needs to hear this episode, please share it with a friend or colleague. And for more information about this episode or any of the resources that we mention in it, please visit our podcast website at onein10podcast.org.