2021 COMBAT Funding: $104,758.07

In MOCSA's Own Words

Two-Pronged Approach

Comprehensive Sexual Violence Prevention in Jackson County is an expansion program that builds on MOCSA’s success with COMBAT in previous years. This program uses a multi-level public health model to prevent sexual assault, child sexual abuse and rape, through two components. 

First, MOCSA’s highly successful Youth with Problematic Sexual Behaviors (YPSB) component is an Indicated/Intensive Individualized/Tertiary Prevention effort targeting youth ages 6- to 14-years-old and their families/caregivers. This provides children and their caregivers the skills and support needed to reduce the youth’s risk of future acts of sexual violence, strengthen protective factors and safeguard against illegal or inappropriate sexual behavior. 

Second, in 2020 MOCSA launched the Kansas City, Missouri Sexual Violence Prevention Coalition (KCMO-SVP), which is a new, Universal/Primary Prevention Component to reduce and prevent sexual assault in the area. The purpose of this component is to implement community-level changes that address the common risk and protective factors of sexual violence and other forms of violence. 

Together, the purpose of this exciting two-pronged program is to prevent sexual violence through both Primary and Tertiary prevention levels and make Jackson County a safer place to live. These two components, combined with MOCSA’s successful Secondary Prevention work in Jackson County schools, provide an ideal, comprehensive public health approach to addressing sexual assault and sexual abuse in the community.  

Serving Youths

The Tertiary Prevention population includes youth ages 6 to 14 years old and their parents or caregivers living in Jackson County who have been identified by the Jackson County Family Court, law enforcement, Children’s Division and the Child Protection Center for reports of inappropriate or illegal, sexually violent behaviors. The Primary Prevention population includes the general population of Jackson County, but will be guided geographically by hotspot maps for violent crime in Kansas City, Missouri.

12- To 27-Week Program

Through Tertiary Prevention, youth and their caregivers participate in a 12-27 week group treatment program utilizing evidence-based practices. Each session lasts 60 to 90 minutes, in which constructive and corrective feedback is used to to teach children and their caregivers about appropriate and inappropriate sexual behaviors, to teach impulse control, and to teach parents/caregivers how to communicate about sex education and implement appropriate sexual behavior rules in the home. 

In addition, caregivers are taught effective parenting strategies, and children are taught to develop plans on how they will follow appropriate sexual behavior rules and learn strategies to increase skills related to coping and self-control. 

Only Rape-Crisis Center

MOCSA is the only rape-crisis center serving Jackson County, and the community has come to rely on this trauma-informed service. In fact, this specific program is one of only two in the state of Missouri—the other in St. Louis—and has been recognized in national publications and media for the impact of MOCSA’s services for Youth with Problematic Sexual Behaviors (YPSB).

At MOCSA, we use the evidence-based Children with Problematic Sexual Behavior-Cognitive Behavioral Therapy model, developed by the University of Oklahoma. This is the only evidence-based program of its kind with standardized treatment methods for youth with problematic sexual behaviors. MOCSA was an initial pilot site of this treatment method in the United States, launching the YPSB program in Jackson County. 

Using Telehealth During Pandemic—And Beyond

As a leader on local and national levels, MOCSA's work in Jackson County has had a significant impact for youth and their families in reducing sexually problematic behaviors and preventing future incidents among children ages 6-14—using the only evidence-based method designed specifically with this population in mind. Counseling for this effective prevention work has traditionally occurred in in-person individual and group sessions. However, in May of 2020, MOCSA also began secure telehealth video therapy for clients using the online platform Doxy.Me in response to COVID-19. 

This has provided flexibility for youth and families, and will become not only MOCSA’s pandemic response, but a standard of care going forward, in addition to our in-person services. As a common, current-day service method, telehealth therapy enhances access for all services. MOCSA has vetted Doxy.Me to comply with the Victims of Crime Act (VOCA) and Violence against Women Act (VAWA). Telehealth services are held from secure locations in MOCSA’s existing office spaces or staff therapists’ homes. 

Home offices meet qualifying criteria, including a closed door, white-noise generating application, and appropriate separation from other spaces to eliminate breach of confidentiality. Staff utilizes remote desktops and virtual-network access, managed by MOCSA’s IT provider, to ensure digital security. Clients complete intake paperwork remotely and can login to Doxy using a computer, tablet, or smartphone—which MOCSA can also provide to families on a limited basis.

Dangers Of Sexting & Pornography

Group sessions are structured in a module format, with each module discussed for one to three sessions. There are 18 modules in the OU-PSB-CBT protocol, and MOCSA incorporates two additional modules to assist families: one on the Dangers of Sexting (sex-related text messages), and one on the Dangers of Pornography, for a total of 20 weeks. (Some children take more or less time.)

Modules that decrease risk factors include: 

• the Sexual Behavior Rules Module, in which youth are taught a foundational knowledge of the sexual behavior rules and boundaries
• the Abuse Prevention & Education Module, which addresses incorrect information, teaches youth how to ask about sexual issues in a safe and appropriate environment, and teaches parents how to communicate with their child
• and the Apology & Behavior Management Module, in which both parents and youth work together to demonstrate knowledge learned and to help prevent future problematic sexual behaviors by acknowledging problems and their effects. 

Overall, these treatment modules reduce the level of high family conflict (an important risk factor) by increasing communication between child and caregiver and giving parents effective skills for establishing boundaries, expectations and supervisory methods to increase child accountability.

Finally, MOCSA convenes a Jackson County Multidisciplinary Team (MDT) for Youth with Problematic Sexual Behaviors. This team consists of MOCSA, Kansas City Police Department, Child Protection Center and the Missouri Children’s Division, and meets monthly to review cases and track youths’ progress through treatment and each partner agency’s respective system.

Coalition Formed

MOCSA’s new effort to implement Primary, Community Level Prevention in Jackson County draws on MOCSA’s expertise and success in Wyandotte and Johnson Counties. In 2020 MOCSA received a contract from the Missouri Department of Health and Senior Services to create—but not implement—a Sexual Violence Prevention Plan for Kansas City. Despite the pandemic, MOCSA has successfully created a multidisciplinary coalition (the KCMO-SVP Coalition), which has together generated a workplan for the community to dovetail with the Violence-Free Kansas City Committee plan for the region: the “Violence Free KC Blue Print”. 

With expanded COMBAT funding, MOCSA will utilize the KCMO-SVP work plan to initiate community-level changes in Jackson County that address the common risk factors of sexual assault and other forms of violence (e.g. intimate partner violence, child abuse), recruit additional community partners to the KCMO-SVP coalition, track progress, and begin measuring our impact in preventing violence. Importantly, approaches that improve characteristics of the community, rather than just individuals within the community, are considered community-level approaches. 

Such approaches can involve changes to policies, institutional structures, or the social and physical environment—all to to reduce risks and increase protective factors that affect the entire community. These changes can have a significant benefit on positive behavior and reducing violence at the individual level (Basile, 2016; p. 26). Examples of our local plan components include neighborhood connection, environmental design changes that improve safety through Crime Prevention Through Environmental Design, and policy improvements that support gender-equity policies and reduce sexual harassment in community organizations. 

One of the key activities focused on this project will be Neighborhood Strategies in the KCMO-SVP plan. Informed by COMBAT Hotspot maps, this project will identify at least one Kansas City neighborhood to implement neighborhood-level violence prevention improvements. Activities will include developing relationships with neighborhood leaders, collaborating with them on detailed strategies for their streets, and connecting them to resources and prevention methods that help them make our communities safer. Potential options for this include CPTED training provided for neighborhood leaders, improving lighting in parks, and publishing a comprehensive Neighborhood Toolkit for residents to use, expected to launch in the Fall.

 Outcomes 

Through Tertiary Prevention among Youth with Problematic Sexual Behaviors MOCSA expects the following outcomes: 

• 95% of youth and families learn the sexual behavior rules and can identify which sexual behavior rule was broken by the child’s behavior;
• 90% of caregivers report an improvement in caregiver knowledge and improved child’s sexual behavior as a result of counseling;
• 90% of youth will reduce the number of problematic behaviors that result in suspensions, expulsions or arrests while participating in the program. 

These outcomes will change knowledge and behavior of the target population and prevent future incidents of sexually violent behavior of children in the program. 

These outcomes are achieved by improving children's behavior through better caregiver monitoring, supervision and behavior management skills, and building effective parent/caregiver-child interactions and communication. Additionally, the children will learn impulse control strategies and problem-solving skills, rules about sexual behavior, privacy and boundaries, and improved coping and social skills. Activities and outcomes for children in the program are tracked in MOCSA’s Athena Penelope 4 (P4) database.

Importantly, this new COMBAT expansion will bookend the important Secondary Prevention work MOCSA currently does in Jackson County schools, funded through other sources. By using Primary, Secondary, and Tertiary approaches, we can decrease violence in our region now, and sustain that improved safety over time.