Attitude Change Following a Diversion Program for Men Who Solicit Sex
M. Alexis Kennedy, Carolin Klein, Boris B. Gorzalka, & John C. Yuille
Published in the Journal of Offender Rehabilitation, Vol 40(1-2), 2004. pp. 41-60
Until recently, prostitution was viewed primarily as an offence committed by women, with little attention being paid to the consumers of prostitution services. However, the last two decades have seen a considerable shift from viewing the prostituted woman as the sole transgressor in the transaction to recognizing that the consumers of sexual services also play a significant role (Monto, 2000).
One consequence of this new focus on the consumer has been an attempt to address the consumers behavior through the implementation of educational programs, or john schools. These programs have the objective of trying to deter participants from soliciting sexual services by educating them about the laws surrounding prostitution and increasing their awareness of the risks they are taking (Monto, 2000; Wortley & Fischer, 2002). In addition to preventing purchasers from re-offending, these programs aim to change consumers attitudes towards prostitution through education about the realities of the commercial sex industry and its impact on prostituted women, on their families, and on communities. In essence, by teaching consumers about the various people who are negatively affected by prostitution and by increasing their awareness about the risks that they are taking by soliciting sexual services, it is anticipated that these programs will change participants attitudes and clients will make a more informed choice about whether they subsequently want to engage in this behavior. These programs, while acknowledging that an arrest in and of itself may be a behavioral deterrent, are designed to go a step further and change perceptions and attitudes held about prostitution.
Instead of (or in some cases in addition to) being processed through the court system, in a number of North American cities, consumers of prostitution are being offered the opportunity to attend these programs. The first john school was founded in the mid 1990s. Since then, john schools have been formed and implemented across Canada and the United States, including such cities as Ottawa, Toronto, Hamilton, Winnipeg, Edmonton, Vancouver, Portland, Las Vegas, Philadelphia and St. Paul.
Researchers who have had access to data from men participating in john schools are contributing to knowledge of who purchases sexual services from prostituted women. For example, Sawyer, Rosser, and Schroeder (1998) administered questionnaires and personality tests to 37 men arrested for attempting to solicit sexual services prior to their participation in a five to eight week psycho-educational program. The researchers found that consumers of prostitution held contradictory attitudes towards prostitution relative to their behavior; many of the participants reported negative attitudes towards prostitution. Another study by Sawyer, Metz, Hinds, and Brucker (2001) assessed the attitudes towards prostitution in 140 consumers of prostitution. Results indicated that older and better educated men were less likely than their younger and less educated counterparts to believe myths about prostitution. Myths that they assessed included attitudes toward women working in prostitution and the significance of purchasing sexual services.
To date there has been very little empirical research on the impact and effectiveness of these john schools. Wortley and Fischer (2002) were the first to publish information on attitude change following attendance at a john school. Three hundred and sixty-six men who went through the Toronto First Offender Prostitution Diversion Program, a post-charge diversion program for men arrested for section 213 offenses, were surveyed. As part of their evaluation, Wortley and Fischer conducted pre-program interviews which included questions relating to demographics, previous use of prostitution, attitudes towards prostitution, and anticipated future use of prostitution. Following the program, participants completed questionnaires containing the same questions as in the pre-program interview regarding anticipated future use of prostitution and attitudes towards prostitution and also filled out an evaluation of the program itself. In addition, Wortley and Fischer conducted follow-up phone interviews with a subsample of participants six months after they had participated in the program. Overall, the researchers found that the Toronto program did result in attitude change as well as in increases in the participants knowledge about prostitution laws and the victims and dangers associated with street prostitution. Participants were then categorized into four groups based on the number of times they had gone to prostitutes in the past (Wortley & Fisher, 2002; Wortley, Fisher & Webster, 2002). These four groups consisted of the Denier, who claimed complete innocence with regards to the prostitution charge and also claimed to have never used prostitutes in the past; the First-Timer, who claimed this was a first attempt at picking up a prostitute; the Novice, who reported having gone to prostitutes between one and four times prior to arrest; and the Sex-Trade Veteran, who reported having used prostitutes five or more times in the past. Analyses revealed that the program seemed to have a greater effect, as measured by attitude change, on First-Timers and Novices than it did on Sex-Trade Veterans.
The purpose of the current study was to evaluate attitude change in men who had completed a different john school diversion program, the Prostitution Offender Program of British Columbia. Similar to the above mentioned programs, the British Columbia program is a community initiated diversion program designed specifically for men who have been arrested under section 213 of the Criminal Code of Canada. The program was founded in 1999, largely in response to complaints from community members about the harmful effects street prostitution was having on their neighborhoods. Administered by the John Howard Society of the Lower Mainland of British Columbia, the pre-charge program is neither a police nor a court initiative.
In line with the findings of Wortley and Fischer (2002), we hypothesized that the program would produce significant attitude changes in participants, with post-program attitudes indicating more agreement with items expressing that prostitution is a problem and more disagreement with items indicating that prostitution is a victimless crime and that women are prostitutes because they want to be. We predicted that the program would have the most significant effects on attitude change in Novices and First-Timers and the least significant effects on the more experienced participants. Moreover, to clarify the effect of experience, we investigated potential interaction effects between experience level and demographic variables such as education, marital status, age, and ethnicity.
The participants were 446 men who attended the British Columbia diversion program for men attempting to solicit sex. All had been arrested under Section 213 of the Criminal Code of Canada for communication for the purposes of prostitution. Demographic information is presented in Table 1 for the whole group, and was collected by the diversion programs staff members at the intake interview. The attitude change measures are reported for a subsample of 341 men. Of the 446 men who attended the program, 69 (15.5%) declined to participate in the research questionnaire component, leading to an 84.5% response rate. Data from an additional 12 participants (2.7% of the sample) were not included in the statistical analyses due to apparent language difficulties identified at the intake interview. Finally, data from another 10 participants (2.2%) were not included due to incomplete data on measures of attitude change or experience level. Since the research component was voluntary and anonymous, participants were informed that they could omit answering any questions which they were not comfortable answering; this may have accounted for the presence of incomplete responses.
Ages of participants ranged from 18 to 89 years (M = 37.5, SD = 11.0) and their ethnic breakdown, marital status, and education largely reflected that of the Lower Mainland of British Columbia (see Table 1). Almost sixty per cent reported being in a committed relationship with 54.3% indicating they were married or in a common law relationship and 5.0% indicating they had a steady partner. The majority (63.7%) had some post-secondary education and 80.8% were employed full time.
In order to provide data to assess attitude change, participants filled out anonymous questionnaires both before and immediately after attending the diversion program. Questionnaires contained a number of behavior and attitude measures including questions from the Attitudes Towards Prostitution Scale (Sawyer, Rosser, & Schroeder, 1998), from the Edmonton Prostitution Offender Program questionnaire (personal communication, 1999), and items written by the first author of this study. In addition, a series of open-ended questions asking about participants evaluation of the program and the impact it had on them were included as was the Marlowe-Crowne Social Desirability Scale (Crowne & Marlowe, 1960).
Attitudes Towards Prostitution Scale (ATPS). The Attitudes Towards Prostitution Scale (ATPS; Sawyer, Rosser, & Schroeder, 1998) is a 15 item self-report scale measuring attitudes, beliefs, and values related to men, family, prostituted women, and prostitution. Agreement with items is indicated on a 5-point Likert-type scale which ranged from strongly agree to strongly disagree. Twelve of the ATPS fifteen items were included in the questionnaires administered to this group of participants.
Additional items. Twenty additional attitude items were analyzed in this study. Seven of the items were provided by the Edmonton program and the remainder were novel. These items include questions about both attitudes towards prostituted women and attitudes toward purchasing sexual services.
Marlowe-Crowne Social Desirability Scale (Crowne & Marlowe, 1960). This 33 item scale was used to identify an exaggerated socially desirable response pattern. On this scale, high scorers tend to present an unrealistically positive pattern in self-reports.
After being arrested by police in British Columbia for section 213 offenses, men who had no criminal record of violence were offered the option of contacting the John Howard Society to enroll in the program. Those who were not eligible upon arrest were processed through the court system. The men were caught in police sting operations in which an undercover female police officer in her 20s or early 30s posed as a prostitute. The majority (89.8%) were given the option following their arrest of attending the program rather than going to court. The remaining 10.2% of the men had been processed through the court system and were sent to the program at sentencing.
The diversion program itself consists of a series of presentations which attempt to educate participants about the realities of street-level prostitution and how their behavior affects others. After a brief introduction by the John Howard Society, a street nurse from the B.C. Centre for Disease Control begins the day by speaking to the participants about sexually transmitted diseases and other increased health risks associated with frequenting prostituted women. The day continues with presentations by police officers from the Vancouver Police Departments Vice Unit who discuss the laws surrounding prostitution and talk about pimp-prostitute relationships and the ways in which most women are recruited into prostitution. They also provide a brief presentation on the Deter and Identify Sex Trade Consumers (DISC) database, an internationally recognized police information management system in which the consumers arrest history had been entered.
In the afternoon, participants hear from people who have been personally victimized by prostitution in some way. A speaker from the community talks about the problems tangential to street prostitution including increased crime and drug use. A mother of a former prostitute tells the story of how her daughter was forced into prostitution by a pimp and the battle to get her off the street. A man whose mother and sisters were prostituted women speaks of the resultant shame and stigmatization. And finally, two or three formerly prostituted women come and share their stories and experiences.
Prior to attending the diversion program, all participants take part in a one-on-one intake interview conducted by the John Howard Society. During this interview, demographic information is collected and participants are asked whether they are willing to participate in a voluntary research component which consists of completing anonymous and confidential self-report questionnaires before and after the program.
The majority of attitude measures considered in this study show statistically significant changes. The pre- and post-program means and t-test results for the sample considered as a whole on the Attitudes Towards Prostitution Scale items are shown in Table 2. Due to the problem of accumulating Type I error across the analyses, a Bonferroni correction was applied to the acceptable significance level, which resulted in an alpha value of 0.002 for individual items. All but three of the twelve ATPS items (It would be ok if my daughter was a prostitute, Most men go to prostitutes once in a while, and I wouldnt mind marrying a prostitute) showed significant attitude change.
Table 3 and Table 4 present pre and post-program means and t-test results for the entire sample on the attitudes towards prostituted women and attitudes towards purchasing sexual services items, respectively. Again, items which were statistically significant after the Bonferroni correction was applied are indicated in the tables. All but three items assessing attitudes towards prostituted women (Most prostitutes just got off to a bad start in life, Juvenile prostitution is more cause for concern than adult prostitution, and Prostitutes are victims of a sexist society) showed significant change, while all eleven items assessing attitudes towards purchasing sexual services showed significant change.
Table 5 presents the items that showed significantly different levels of agreement when the sample was divided by levels of experience with prostitution into First Timers, Novice, and Experienced clients, the latter referred to as Sex-Trade Veterans by Wortley and Fischer (2002). In contrast to Wortley and Fischers analyses, the present analysis did not include a Denier group because all men who participated in British Columbias program acknowledged responsibility prior to attending. Two of the 12 Attitudes Towards Prostitution Scale items showed a difference prior to the education program (pre-program) based on the experience level of the participant. For the item, There is nothing wrong with prostitution, Experienced participants were significantly more likely to agree with this statement than First Timers or Novice participants. For the item, It would be OK if my son went on his own to a prostitute, Experienced participants were again significantly more likely to agree with the statement than the other two groups pre-program. None of the twelve items showed a significant difference in response choice by experience level following the education program (post-program). Despite the different starting levels for the two items mentioned above, none of the twelve items showed significantly different rates of change by experience level at the corrected alpha level of 0.002.
For the nine items assessing attitudes towards prostituted women, all three experience levels showed similar responses. There were no significant differences pre-program, post-program, or in the rate of change.
Three of the 11 items assessing attitudes toward purchasing sexual services showed pre-program differences by experience level. For the item, If my wife or partner does not satisfy me sexually, it is okay for me to go to a prostitute, First Timers and Novices were more likely to disagree with this statement than Experienced participants. For the item, Prostitution is a serious problem in our society, the First Timers were more likely to agree than the other two groups. Finally, for the item, We need tougher laws to deal with prostitution, First Timers were more likely to agree with this statement. Using the corrected alpha level of 0.002, none of the 11 items showed a significant difference by experience level post-program. There were also no significant differences in rates of change on these items by experience level.
Differences in the demographic composition of the three levels of experience groups were considered as potential explanatory factors. The three groups did not vary significantly by education level (F (2, 338) = 2.357, p = .096) or marital status (F (2, 338) = 0.109, p = .897). The groups did vary significantly by age (F (2, 338) = 6.77, p = .001) and ethnicity (F (2, 337) = 4.641, p = .01). The average age of each group increased with experience level; First Timers average age was 35.6, Novices average age was 36.7 and the Experienced groups average age was 40.2. The Experienced group had the highest proportion of European-descent participants (63.4%) compared to the Novice (53.8%) and the First Timer (44.2%) groups. The First Timer group had the highest proportion of Indo-Asian participants (26.3%) compared to the Novice (13.8%) and Experienced (7%) groups. The First timer group had fewer Chinese participants (6.4%) compared to the Novice (12.4%) and Experienced (13.4%) groups. The three groups were similar for the other ethnicities (i.e., Southeast Asian, Afro-Caribbean, North African-Middle Eastern, Hispanic and other).
Significant differences in pre-program attitudes were found for five of the 32 items when participants were considered by ethnic group. Only the ethnic groups with over 30 participants (e.g., European, Chinese, Southeast Asian and Indo-Asian descent) were considered in these analyses. Post hoc analyses are presented in Table 6 for these items and indicate which ethnic groups varied significantly from each other. For the item, There is nothing wrong with prostitution, the Indo-Asian group was more likely to disagree with this item than the other three groups. For the items, As long as a mans wife does not know about it, there is no harm to the marriage if a man goes to a prostitute, and If my wife or partner does not satisfy me sexually, it is OK for me to go to a prostitute, the Chinese group was less likely to disagree than the other three groups. For the item, It would be OK if my son went on his own to a prostitute, the Indo-Asian group was more likely to disagree than the European or Chinese group and the Southeast Asian group was more likely to disagree than the Chinese group. Finally, for the item, No matter what society tries to do, prostitution will always exist, the Indo-Asian group was significantly less likely to agree with this statement than the other three groups. There was only one item that showed a significant post-program difference at the 0.002 significance level; for the item, Most prostitutes just got off to a bad start in life, the Indo-Asian group was more likely than the European descent group to agree with this statement. There were no significant differences in attitude change when considered by ethnicity.
When considering the relationship of experience level to attitude change concurrent with the relationship to age, there was no main effect of age. It appeared that age, despite differing for the experience level groups, did not significantly affect attitude change.
With respect to social desirability, participants as a whole had a mean score of 18.68 (SD = 6.27). Using Andrews & Meyers (2003) methodology for comparing previously reported means for social desirability scores, the mean reported in our study was not significantly higher (d = .495) than the means reported for normative data in a Canadian sample of community members and university students (M = 15.81, SD = 4.88) (Loo & Thorpe, 2000). Thus this Cohens d (calculated, as in the 2003 report, by dividing the differences of the means (15.81-18.68) by the pooled SD (5.8)) did not exceed the 0.5 cut-off for a medium effect size. Using the same methodology, Cohens d was only .12 when our mean was compared to normative data for the forensic sample (M = 19.42, SD = 6.44) presented by Andrews & Meyer (2003). Unlike Andrew and Meyers large effect sizes which allowed them to conclude that their forensic and non-forensic samples appeared to be coming from different populations, our sample only showed small effect sizes when compared to different populations.
Social desirability scores did not correlate with the degree of attitude change for all but two items. For the item, Prostitution exists because of the demands of customers, higher levels of social desirability were positively correlated with greater change towards agreement with this item [r = .144, p <.01 (two-tailed)]. For the item, We need tougher laws to deal with prostitution, those with lower social desirability scores showed the greatest change towards agreement [r = -.148, p <.01 (two-tailed)] and those with higher social desirability scores agreed more with this item before and after the program, but the degree to which their responses changed was less than that associated with lower social desirability scores.
The three experience level groups varied slightly from each with respect to their levels of exhibited social desirability (F = 3.182, p < .043). Post hoc analyses revealed that the First timer groups scores (X = 19.54, SD = 6.2) were significantly higher than the Experienced groups scores (X = 17.56, SD = 6.4). The social desirability levels for the Novice group did not differ from the other two groups (X = 18.28, SD = 6.4).
The results of this study indicate that the British Columbia diversion program appears to significantly change attitudes towards prostitution, towards prostituted women, and towards purchasing sexual services in male clients of street prostituted women. More importantly, all of the attitude changes occurred in the direction expected by the program.
On the Attitudes Towards Prostitution Scale items developed by Sawyer, Rosser, and Schroeder (1998), only three items did not show significant attitude change following the program. For the item It would be ok if my daughter was a prostitute, the lack of significant attitude change reflects very strong disagreement prior to the program with little room for participants to disagree even more. On the item Most men go to prostitutes once in a while, there was no significant attitude change, with attitudes remaining neutral on this item. For the item, I wouldnt mind marrying a prostitute, attitudes also remained in the neutral to disagree range following the program. It is not overly surprising that these latter two items did not change considering that the program does not address these topics. In fact, the numerous significant changes found with items developed by Sawyer, Rosser, and Schroeder (1998) are somewhat surprising in light of the fact that these items were not designed to measure pre and post-program attitude change.
Three items did not show significant change among the attitudes towards prostituted women questions. Attitudes toward the item, Most prostitutes just got off to a bad start in life, stayed fairly neutral following the program. A neutral position may support two messages conveyed in the program: first, it is reinforced by a number of the speakers that anyone can get lured into prostitution; and second, contrary to a commonly held myth, not all prostituted women were abused as children. The second item which showed no significant attitude change, Juvenile prostitution is more cause for concern than adult prostitution, again may be due to very strong agreement with this statement prior to the program, leaving little room for participants to increase their level of agreement. The third item, Prostitutes are victims of a sexist society, remained fairly neutral following the program. This item was somewhat abstract and theoretical compared to the other items and was not specifically addressed during the diversion program. All items referring to attitudes toward purchasing sexual services showed significant attitude change following the diversion program.
Somewhat surprising were the findings with respect to attitude change by experience level. In contrast to Wortley and Fischers (2002) findings, attitude change following the British Columbia program did not vary by experience level. Nor did any of the items show significantly different rates of change by experience level. In fact, the only consistent pattern was that First Timers tended to show less attitude change than the other two groups of participants. These findings also contrast with those of Wortley and Fischer (2002) who found that Experienced participants showed the least amount of attitude change following the Toronto program while Novices showed the most.
Experience level did not interact significantly with other variables such as age, marital status, or education. While the three experience level groups did have different average ages, simultaneous comparisons of age and experience did not lead to any main or interaction effects for age on attitude change for the individual items. Ethnicity did not affect attitude change either. While a few items showed different starting attitudes by ethnic group, the final responses seen after the program did not vary for ethnicity across the 32 items.
Statistically, the British Columbia program showed a consistent level of attitude change across all three experience levels. This differed from the results of the Toronto program (Wortley & Fischer, 2002). While this paper was not intended to provide a direct comparison to the Toronto program as different items were used to measure attitude change, the differences in results bear some consideration. A number of procedural and content differences between the Toronto program and the British Columbia program may help to explain why our results differed from those of Wortley and Fischer. As mentioned earlier, while the Toronto program is a post-charge diversion program, the British Columbia program, for most participants, is pre-charge. This difference may have led to some British Columbia participants indicating more attitude change than actually occurred out of participants fear that if they put down their true attitudes it could have an impact on their charges being dropped. Despite an emphasis at the intake interview that participation in the research component of the program was voluntary, anonymous, and not related to the successful completion of the program, participants answered in a socially desirable direction; participants scores on the measure of social desirability were slightly, although not significantly, higher than those found in normative data for community/student samples and similar to those found in normative data for forensic samples. However, as social desirability scores of the Toronto program participants are unavailable, it is unknown whether the British Columbia program participants showed comparatively higher levels of socially desirable responding or not.
The Toronto program and the British Columbia program also differ in the approach they take. The program in Toronto tries to educate its participants through a confrontational shaming ritual (Wortley, Fischer, & Webster, 2002, p. 373). The British Columbia program, on the other hand, makes every effort to leave shaming out and instead tries to teach its participants about street prostitution within an atmosphere of mutual respect. These differing approaches may have an impact on the degree of attitude change experienced by participants in the sense that some participants may be turned off by the shaming approach and may then resist much of the information being presented. This may be particularly true for the Experienced participants, who may have normalized their behavior, thereby not feeling any shame nor responding to this approach.
Another difference between the two diversion programs is that the Toronto program includes a presentation by two former consumers of prostitution from Sex and Love Addicts Anonymous (SLAA) who talk about sexual addiction and about the possibility that some of the participants may also have an addiction to sex. While the British Columbia program originally considered including a similar presentation in its program, it was ultimately rejected due to a concern that such a presentation would give participants the opportunity to justify their behavior, thereby ignoring or resisting the information being presented on the realities of street prostitution. It is possible that this is exactly what happened in the Toronto program. Wortley and Fischer (2002) found that 42% of participants indicated that they either had or might have a sexual addiction following the program, compared to only 11% before the program, and the impact seemed to be greatest for experienced participants 44.3% changed their responses to admitting they might have a sexual addiction problem following the school.
Finally, the Toronto program and the British Columbia program differ in their class sizes. The classes in Toronto range in size from 25-45 participants, while in British Columbia, class sizes never exceed 25. Perhaps the smaller class size forces more of the men to participate, thereby investing more into the program and absorbing more of the messages being presented.
Besides the above mentioned differences between Torontos and British Columbias programs, two other differences pertaining to the demographics of the two samples need to be noted. The first is that a much larger percentage of participants attending the British Columbia program were in a committed relationship compared to those attending the Toronto john school (59.4% vs. 46%). It may be that the British Columbia program had a greater effect on Experienced participants because more of them felt guilt about having betrayed their partners. The second difference is that the sample of participants attending the British Columbia program was more educated than the sample attending the Toronto program; while only 48% of participants in Toronto had some post-secondary education, 63.7% of British Columbias participants did. Wortley and Fischer (2002) found that those with more education demonstrated more post-program change than others.
Overall, these results suggest that the British Columbia program may be a successful way of changing the attitudes that these men hold towards prostitution and prostituted women. The finding that, for the most part, the program had an equivalent effect on participants regardless of their experience level suggests that prior experience does not reduce the value of an educational diversion program as a viable option for men arrested for soliciting sexual services.
Although the current research represents a significant advance in the empirical investigation and evaluation of diversion programs for men arrested for soliciting sexual services, several important limitations and considerations need to be taken into account. The current findings cannot be generalized to all consumers of prostitution as only those with no prior sexual and violent offences were allowed to participate in the program. It is likely that individuals who have a history of criminal violence would not show the same degree of attitude change as individuals whose only experience with the criminal justice system was for soliciting sex. In addition, 15.5% of the participants who attended the program did not participate in the research portion; it is possible that some men did not participate because of strong negative feelings towards the program, and that, had they filled out the questionnaires, they would have shown considerably less attitude change than what has been reported.
Another consideration which needs to be taken into account is that participants may have indicated attitude change because they were more aware of the correct response following the program, but that in actual fact the program did not have a lasting impact on their attitudes. An important focus for future research will be longitudinal studies tracking recidivism and investigating whether john school diversion programs like the British Columbia program have a lasting effect on both behavior and attitudes. Moreover, there was no control group of non-consumers attending the education program. Perhaps their level of attitude change may have been greater.
Finally, while the findings are statistically significant, they arent necessarily clinically significant. In order to assess whether the findings are clinically significant and to be able to confirm that this type of diversion program is in fact a better way of dealing with solicitation offenses than the court, potential participants would need to be randomly assigned to either attend the diversion program or to be processed through the court system. In addition, other variables which could affect the degree of attitude change, such as attitudes toward women and psychopathology should be investigated.
In light of the current quest for more effective ways of dealing with consumers of prostitution, diversion programs like the British Columbia program seem to offer a viable and inexpensive alternative to charges, fines, and jail time. In addition to the deterrent effects of being arrested, these diversion programs seem to hold some promise of changing attitudes in the long-term, and thus may also have an impact in changing many of the current myths and misperceptions about prostitution and prostituted women in general.