IT IS OFTEN SAID THAT some images are so powerful, they cannot be "unseen." Images of child sexual abuse (CSA) fall into this category, as they can record abuse far beyond the boundaries of moral acceptability, and so be shocking and sometimes traumatizing. In Canada and many other jurisdictions, laws and professional ethics tightly control the viewing of such images, largely to prevent further harm to the child pictured (Slane 2010). For professionals who work with these cases, the potential costs and benefits of viewing CSA images involve complex issues, and must include a legitimate purpose not only to respect the victim, but to protect the viewer and help maintain job satisfaction (Martin 2013).

This article explores attitudes among professionals in Internet child exploitation law enforcement (ICE), child protection (CP), and children's mental health (CMH). It does not focus specifically on the traumatic effects of seeing the images. Instead, it examines the professional knowledge and expertise held by ICE investigators, and whether and how viewing images increases knowledge and expertise toward best practice responses to child victims. It further queries whether viewing these images has value for CP and CMH professionals, in relation to specific cases or training contexts.

Using focus groups, the primary aim of our study was to identify the gaps and barriers to the collaborative creation of new knowledge for best practice responses to victims of child sexual abuse images online (CSAIO). Here, we use the term CSAIO to encompass all CSA material featuring real children. This article examines one prominent theme in our findings, related to when and whether professionals who work with CSA cases should be exposed to CSAIO, and to what end. In a broader sense, this article is about professional experience, decision making, training, and collaboration around a particularly difficult professional experience, namely exposure to viewing CSAIO.

LITERATURE REVIEW

In many countries, including Canada, images of CSA are the subject of the strictest legal prohibitions. Canada's Criminal Code s. 163.1 sets out offences related to "child pornography," which includes images of a person under 18 depicting explicit sexual activity or the sexual organs or anal region of a child for a sexual purpose. These offences include accessing child pornography, which is defined as having been committed by a person who "knowingly causes child pornography to be viewed by, or transmitted to, himself or herself' (Criminal Code s. 164.1(4.2)). A defence against this offence is that the person who knowingly viewed child pornography did so for a "legitimate purpose related to the administration of justice, or to science, medicine, education or art" where that act "does not pose an undue risk of harm to persons under the age of eighteen years" (Criminal Code s. 163.1(6)). The Criminal Code thus recognizes the professional contexts where viewing CSAIO has legitimate purposes, especially where that work intends to benefit victims rather than exploit them. Nonetheless, the balancing of purpose with risk of harm to children is always pertinent to discussions about viewing CSAIO (Martin 2013, 2015; Slane 2015).

Viewing CSAIO can also harm these professionals. Krause (2009) reported that repeated exposure to CSAIO is one of the top four stressors among policing professionals. The volume and depravity of CSAIO to which ICE professionals are exposed is particularly concerning (Burns et al. 2008), especially when they are not adequately prepared (Whelpton 2012). Ongoing exposure to CSAIO can lead to higher secondary traumatic stress (Brady 2017), distrust (Craun, Bourke, and Coulson 2015), overprotectiveness (Whelpton 2012), intrusive thoughts (Burns et al. 2008), and the inability to forget images (Cruz 2011).

Although ICE work has many stressors, it can also be rewarding and fulfilling, potentially counterbalancing or reducing the negative effects (Sinclair, Duval, and Fox 2015). Researchers have found that despite difficulties, ICE professionals are proud of their jobs (Burns et al. 2008), believe their work makes a difference (Perez et al. 2010), and feel a calling to protect and care for children (Whelpton 2012).

Collaboration and training across sectors is one successful method toward producing knowledge about best practices. Working in multidisciplinary teams is said to cause less trauma for children and families, and leads to better decisions, more efficient use of resources, and less burnout (Ells 2000). This is the reasoning behind the establishment of Child and Youth Advocacy Centres (CYAC), which centralize all the necessary services for child victims (Herbert and Bromfield 2016; Jones et al. 2007; McDonald, Scrum, and Rooney 2013). A recent review found evidence that multidisciplinary teams are more effective in improving mental health compared to standard practice (Herbert and Bromfield 2017). Collaboration between law enforcement and CP professionals (Cross, Finkelhor, and Ormrod 2005), and between CMH and CP professionals (Bai, Wells, and Hillemeier 2009), has been shown to improve coordination of investigations and to benefit children.

Collaborative training can also be valuable. Joint training between law enforcement and CP was found in one study to increase understanding of others' roles, and helped to develop and continue professional relationships that facilitated information sharing and ensured people were "on the same page" (Stalker et al. 2007:127). However, evidence about precisely how joint training improves practice is lacking (Charles and Horwath 2009).

Collaboration involves various challenges. Cross et al. (2005) found issues with the relationships between CP and law enforcement professionals in CSA investigations, including friction and interference. Across child services, Horwath and Morrison (2007) note that issues can include lack of ownership, rigid systemic structures, clashing professional identities, lack of budget control, communication problems, mistrust, and not understanding others' roles.

Similar studies have not been conducted regarding collaboration and training related specifically to CSAIO, and few multidisciplinary teams with that specific capacity have been established in Canada. However, the findings from a groundbreaking Canadian study that explored practitioners' understanding of CSAIO (Martin 2013) "strongly indicated to combine training specific to CSAIO with children's mental health, child welfare, and law enforcement professionals in order to 1) help to increase understanding of the mandate of professionals in each of the other systems that respond to child sexual abuse, and 2) enhance communication between systems so that these children are not missed" (p. 141). Ontario is the only province to have a multidisciplinary strategy involving law enforcement, CP, prevention, and research (Gelder, Gingras and Associates 2016). Only one CYAC currently addresses CSAIO; it has made recommendations including ongoing coordination and knowledge sharing across sectors (Rimer 2008).

Given the specialized nature of ICE work, CSAIO may complicate collaboration and joint training in unexamined ways. This may include shifts in expertise regarding the nature of the abuse experience of victims. According to CP professionals, when CSA came to the forefront of public focus, many police officers were reluctant to do these investigations and to interview child victims (Stalker et al. 2007). CP and CMH professionals continue to see themselves as experts in CSA, but now generally consider law enforcement to be experts on CSAIO, largely due to the role played by technology (Martin 2016). While there is substantial literature regarding preparation and self-care for CP and CMH professionals working on difficult cases, specific research about working with CSAIO in these professions is sparse (Martin 2014).

This study addresses multiple research gaps. The existing literature focuses on stress and trauma caused by viewing images, along with coping strategies, but has not explored the utility of viewing images. This study adopted a cross-sectoral framework involving multiple professions that may be exposed to CSAIO. The findings yielded unique insights and recommendations for interaction within and between these sectors, which may be applied in the Canadian context and beyond.

METHOD

This exploratory study was based on 12 multisite focus group interviews conducted with ICE (3), CP (2), and CMH (5) professionals, as well as multisectoral groups working through a CYAC (2). All focus groups took place at partner specified sites in Ontario, between October 2015 and March 2016. All groups were restricted to supervisors or practitioners/investigators, with the exception of one ICE group. In total, 84 participants took part: 27 ICE, 12 CP, 30 CMH, and 15 CYAC professionals. Groups consisted of 3 to 13 participants, with a majority having 6 to 7. Participants received a questionnaire asking about years of experience with CSA and CSAIO, with 61 completed (12 ICE, 14 CP, and 35 CMH, including those in CYAC groups); the questionnaire did not ask about further demographics.

The focus group discussions ran on average 1.5 hours, and were recorded and transcribed. The lead authors asked each group the same questions, including questions about what insights or knowledge they had gained from their professional experience with CSA or CSAIO, what expertise they thought important to share with professionals in other sectors, what they would like to learn about CSAIO from professionals in other sectors, and what information about CSAIO should be more broadly available within their own sector.

Inductive analysis techniques, consistent with the constant comparison methodology (Glaser and Strauss 1967), served to develop conceptual understanding of the data. Analysis began with line-by-line coding in NVivo software (QSR International (Americas) Inc., Burlington, MA). Codes were clustered in two stages according to themes and subthemes, with attention to frequency, consistency, and outliers (Rabiee 2004). We identified three to four major themes for each sector, each containing two to five subthemes. We generated conceptual mind-maps to visualize the data both within and across sectors. The final stage entailed member-checks with both participants and the project's partner stakeholders. All participants met the inclusion criteria of experience working with CSA and/or CSAIO. Participants were promised confidentiality, and therefore any identifying information has been removed. The study protocol was approved by the ethics review board at the universities of both lead investigators.

The methodology used resulted in some limitations. First, the sample was small, from only one province, and did not include the same number of groups or participants for each sector: the results are therefore not generalizable. Second, splitting groups according to participants' roles meant that the researchers were not able to engage those at different organizational levels together. It is also possible that, while voluntary, the focus group setting could have resulted in participants omitting information they did not want to share in the presence of colleagues. Third, it was difficult to generalize about CYAC participants: they were professionals from all three sectors who worked at one agency with an integrated, collaborative model. Unless they expressly self-identified with a sector, it was challenging to discern their role, as well as whether they were speaking from their sectoral perspective or as a member of the CYAC collective. Disparities in level of experience working with CSAIO were also more pronounced between ICE and professionals in CP and CMH than anticipated. Finally, we were unable to include law enforcement participants who only had experience working with CSA and not CSAIO, although this level of experience was most common among participants in the other two sectors.

The methodology also had particular advantages. First, the use of focus groups enabled the inclusion of a larger sample than would have been possible with individual interviews, and provided richer data than surveys. Groups allowed researchers to hear participants' responses and observe their exchanges. Varying perspectives were brought forth, challenged, or agreed upon, which helped establish patterns and outliers across and between participants, groups, sectors, and the sample. Second, while splitting groups according to managerial level was limiting, it also meant that participants might have been more comfortable to speak candidly in the absence of their superiors or those they supervised. Finally, while it was difficult to generalize about the CYAC, it afforded a perspective from professionals who worked together in a uniquely collaborative environment, with specific experience working together on cases involving CSAIO.

FINDINGS

Experience viewing CSAIO was the strongest distinguishing characteristic between ICE participants and other participants. Many ICE professionals referred to the knowledge they had acquired about both the phenomenon of CSAIO generally and the abuse experiences of specific victims, especially as arising from their extensive exposure to images. They identified various ways to convey this knowledge to others in law enforcement who are not in ICE units and to the other two sectors. Some were sensitive to the different roles played by professionals in relation to child victims and how these professionals might not need to see the images to do their jobs and could instead be told of content. Several (i.e., across two ICE groups or at least three participants) were adamant that there is no replacement for seeing the images. CP participants in CYAC groups were more likely to have worked closely with ICE professionals on CSAIO cases, and so were more likely to express opinions about when and whether they needed to see images as part of their CP investigation roles. No CMH participants said they needed to see images to do their work, and none mentioned wanting to learn about the content of images (generally or as related to specific victims) from law enforcement professionals.

Our findings regarding the utility of exposure to CSAIO can be divided into two broad categories: (1) the phenomenon of CSAIO generally and (2) the abuse of specific child victims. Within both categories, participants who had been exposed to images discussed their experiences, including what is gained from that exposure, and what the personal, social, and professional costs are or might be.

Category 1: Knowledge about the Phenomenon of CSAIO Generally

Extensive knowledge about the phenomenon of CSAIO derived from viewing images was a prominent theme among all ICE groups. Because of the disparity of experience among focus groups, the only other participants who claimed significant knowledge about the phenomenon of CSAIO were some CP professionals, mostly in CYAC groups. We organized participants' comments into three subcategories that reflect the complexity that viewing CSAIO can add to working with such cases, as presented below.

A. "Until you actually see it, you can't even wrap your brain around it." This subcategory refers to knowledge gained by ICE participants from viewing CSAIO. Most considered the experience of viewing CSAIO to be more shocking, more disturbing, and generally unlike any other of their professional experiences. They felt their exposure to viewing CSAIO had granted them expertise that cannot be acquired in any other way.

Several ICE participants discussed their first exposure to CSAIO in the course of the screening process while applying to join an ICE unit: part of this process involves providing applicants with a sample of images, so that applicants have an opportunity to anticipate what the job will entail. Despite being forewarned of this aspect of the screening process, these participants stated that they still felt unprepared and were shocked by the images, and only then understood their extreme nature. One participant described the contrast between their understanding of CSAIO before and after doing ICE work in graphic terms:

I remember someone saying to me [...] it's not like anything you've ever done and I said, oh I know, I've done a ton of interviews in the field and lots of investigations and she said it's not the same thing and I'm like, yeah, sure, okay, yeah, sure. And she was right; it's not. Hearing from a child, he raped me or he put his finger in my vagina, is like hearing those words but actually seeing the image is like two completely different things. Like, you can't even, until you actually see it, you can't even wrap your brain around it really (Group 3, P7)

Despite the graphic words this participant used to describe the content, they insisted that viewing the abuse in a photograph is "completely different" than hearing it described.

B. It is complicated. ICE participants acknowledged that the ability to view CSAIO is complex and varies by individual. Many believed that they were especially suited to the work because they were able to manage the personal effects of viewing abuse images better than others: "[...] some people can handle it. The images. And some people can't" (Group 1, P2). However, ICE participants also described some tension with those outside ICE units over the implications of being able to do this sort of work. Three main themes emerged within this subcategory, as described below.

i. "It's gonna do more benefit than harm." Several ICE participants said that viewing CSAIO can be deeply disturbing, and that the content can be "horrific" (Group 1, PI), but that the personal cost of viewing is outweighed by the "greater good" of rescuing children from abuse (Group 3, P4). As one said, "you're gonna be tainted for the rest of your life, but you know what, you're saving a bunch of kids [...] like I say ... greater good You' 're taking on this responsibility, we're gonna show you this stuff and it's gonna do more benefit than harm" (Group 3, P4). ICE participants thus expressed maintaining a balance between the negative personal effects of viewing CSAIO and the satisfaction of rescuing children from further abuse.

ii. Seeing CSAIO "for what it really is." Many participants across all ICE groups stated that through working in ICE, they came to see the images as depicting a "crime scene" (Group 1, PI) which fit in with their professional obligation to investigate crime. Many also said that all law enforcement officers should be able to deal with doing ICE work, in the same way they deal with other types of disturbing situations. The following conversation took place in Group 3:

P1: I think everybody should be exposed to it because it's too easy for members to say oh, I don't wanna see that. Or, oh, I'd never work in that unit, I can't do it. But it's okay to go to a car accident and see someone in the car mangled. [...] How you deal with it? They'll provide you with the tools to help you after the fact. But these people have to live with it, the least you could do is step up and deal with it without, instead of being the adult that says, ugh, not today.

P2: And scared of it [...].

P11: Yeah, I don't think we should even have that option. [...] I think you need to be exposed to it and know it's part of the job."

This reflects the idea of the "greater good" discussed above, in that the "crime scene" orientation emphasizes the purpose of viewing the images as "stepping up" for the sake of child victims. Comments like these reflected a key source of satisfaction for ICE participants, which helped balance the burdens of viewing CSAIO.

iii. "They kind of look at you like you're weird." Many ICE participants reflected on other people's reluctance to even talk about CSAIO. One said, "when you talk to people who aren't on the job and they find out what you do, and they look at you like you're nuts" (Group 2, P9). Several also noted that non-ICE colleagues in law enforcement expressed aversion to the work, such as this conversation in Group 1:

P2: We get officers saying how do you do that ? Right?

P1: That or we're glad YOU do it. [...] Like I am glad somebody's doing it, I can't do it.

P2: I can't do it [...] Then they kind of look at you like you're weird.

Two participants in another ICE group said the attitude of "I could never do that" was "insulting" in that "It's almost assuming there's something wrong with you" (Group 3, P8 and P9). This also builds on the ideas of "greater good" and "crime scene" discussed above. Participants felt not only that there is nothing "wrong" with them, but that they were doing responsible police work--and so rescuing children--that some other law enforcement officers were shirking by refusing to do ICE work.

Several ICE participants speculated that their non-ICE colleagues might be internalizing this attitude, fearing that if they could do this kind of work there might be "something wrong" with them, and therefore rejecting it:

[...] it's like, they don't wanna admit that, maybe I wouldn't mind it, there's something wrong with me because I wouldn't mind doing that job so therefore oh my god that's so disgusting I could never do it. Like it's almost like this internal that's disgusting, I wouldn't wanna do it because what if I could do it and it wouldn't bother me, is there something wrong with me. (Group 3, P1)

One described this kind of fear in gendered terms: "I'll emphasize that even more from a male point of view because let's face it [...] 95% of the offenders are male. Right? So, men tend to be again petrified of it [...] it's like Kryptonite and no one wants anything to do with it" (Group 1, P3). This participant suggested that especially male non-ICE members feared that being willing to work in ICE implied they would view images for the wrong reasons--in ways similar to offenders.

Two other participants, including a CP participant in a CYAC group, immunized their legitimate viewing of CSAIO from these damaging assumptions with passing comments of "I'm not thinking dirty" (Group 1, P2) and "it's not voyeuristic" (Group 11, P7). They felt that the personal implications of being able to handle viewing CSAIO had a down side beyond the direct emotional impact, namely that they also had to be able to handle unstated suspicions about motivations for doing the work.

C. Showing CSAIO to other professionals within and across the sectors. The next subcategory involved the possible benefits and cautions related to showing CSAIO to non-ICE professionals. As discussed below, this involved two main themes, which further reflect the complex balancing of costs and benefits to being exposed to CSAIO explored above, including whether or not the benefit of seeing images is clear to non-ICE professionals.

i. "Things that the average person couldn't even imagine." As noted above, ICE participants described their own experience of exposure to CSAIO as profoundly eye-opening. The perception that there is no substitute for seeing the images informs the controversy regarding showing images to non-ICE professionals in trainings, given that, as one ICE participant put it, "we're looking at things the average person couldn't even imagine" (Group 1, PI).

One CP participant described organizing trainings where images were shown, and defended this choice as necessary to dispel misconceptions "so that people are very clear around what we're talking about when we say images of sexual abuse," because "most people think it's the picture of the naked kid on the beach" (Group 4, P6). This participant stated that attendees acknowledged they had underestimated the severity of abuse prior to the training: "you'd be surprised the amount of people in that audience that really didn't have a clue about what it was exactly [...] that's the comments that we get, that they would've never imagined that that is what we're referring to, and that that's what we need to be asking children about, as part of their abuse in this day and age." In line with the idea of "greater good," this CP participant similarly stressed that exposure served an important purpose, namely to dispel misconceptions tending to minimize the abuse depicted in CSAIO. In contrast, as discussed in more detail below, several CMH and CP participants said they had been subjected to images during training or conferences, did not understand the purpose for it, and did not agree that the benefit outweighed the potential harm.

Other ICE participants also expressed frustration with people who did not appreciate the urgency of doing and supporting ICE work, and suggested shocking others into action by showing them CSAIO. One ICE participant complained that people in positions of authority are not prioritizing ICE funding and support, and suggested that these people should be shown more extreme images to inspire them to action: "should the Prime Minister see it? Damn right. [...] let them see exactly what is going on to these children. If they're impacting laws and funding and all these things that hinder policing, then we need to share that full picture" (Group 3, P3).

ii. "That wasn't necessary." By contrast, some participants thought that professionals might be dissuaded from attending CSAIO training sessions if they thought they were going to be exposed to images, especially if they were not adequately prepared. One CMH participant described being so exposed without preparation, commenting, "I will never ever forget that image and that is very, very difficult even for us as professionals [...] feeling like we can't do anything to help because no one knows who that little girl is or where she is" (Group 8, P5). A CP participant said, "We go to these conferences and sometimes the images that are shown, many of us look at each other and say, that wasn't necessary like why? [...] for some people it's like oh no, I don't wanna go to a session about that and learn about that because I went once before and they showed this stuff' (Group 12, P2).

Reflecting the idea that it can be difficult to even acknowledge being able to handle viewing images, one ICE participant said, "No normal human being wants to see this stuff, so [...] who's gonna say oh yeah, that should be the way we have to do it cuz most of the folk don't say yes to that" (Group 3, P9). Another ICE participant believed that exposing law enforcement members to CSAIO during general training had the effect of discouraging applications to ICE units, commenting "as soon as they did that block training we never got people applying for the job anymore because they were like I'm not doing that crap" (Group 2, P5).

Some participants described strategies to lessen discouraging effects of exposure to CSAIO in trainings, ranging from giving "ample warning that the images are gonna come up and normally what we ask of people is that they, at least for the first image, that you glance up so that you can at least get an idea of what we're talking about" (Group 4, P6) to not showing images but rather describing their content. However, because only one participant (from a CP group) spoke about having made the choice to show images in a training, our findings regarding an expressed positive rationale for showing images to CP and CMH trainees is limited.

Overall, these findings reflect the important balance between a clear benefit with the potential negative effects on trainees. The following discussion builds on this idea to explore what knowledge can be gained from viewing images related to specific children in a professional's care.

Category 2: Knowledge about the Experiences of Specific Child Victims

This section explores the utility of viewing images related to the abuse of particular victims. Again, the level of exposure to CSAIO varied significantly between ICE participants and most others, although a few CP participants in a CYAC group had some exposure to images of children with whom they were working. No other participants mentioned having seen images related to particular clients. Three subcategories emerged from focus group discussions, as presented below.

A. "We see ALL the images, we know the WHOLE backstory.'" Many ICE participants described having a lot of detailed knowledge about the abuse of particular child victims, and that viewing images drove home the urgency of rescuing that child. Some said that to carry on working, they needed to be able to move on after a child is identified and removed from the abusive environment, and not think about the ongoing emotional difficulties that the child will likely face:

You work on a file for four years and you're listening to the sound, you're listening to the dude's heartbeat practically and these audios and you're so close and then they save the kid and you're like, oh, okay good, I'm happy [...] now I can move past this. And then you're going onto another one [...] do I wanna find out that the kid turns out to get abused again? I hope not. [...] I want the positives. Not the shitty. (Group 3, P3)

However, several ICE participants speculated that it might be useful to share highly specific information with professionals providing ongoing support to victims. One said this could give them "the inside track on how that child was abused, the nature of the abuse, how the abuser broke down all those barriers and was able to get in and most likely in secret for a prolonged period of time," which might give a CMH practitioner "a much stronger advantage to be able to help that child" (Group 1, P2). Another said, "we're in the house, you know, we see all the images we know the whole backstory [...] there's a lot of information that perhaps we can give so that they don't have to start from scratch" (Group 1, P3).

B. "If I'm going to look at it [...] it's for a purpose." One CP participant in a CYAC group said that sometimes it is helpful for CP workers to view CSAIO, even though doing so is very difficult especially when they know the child: "I've just interviewed this kid, and again, there's a bit of a difference between seeing images of kids you don't know versus the one that's just in the waiting room [...] but a lot of times kids omit all of the details, so sometimes when we actually do get the images back, it's worse than we thought or there's more of what we thought" (Group 11, P7). This participant also noted, "maybe by looking at the images it gives us more insight into either what happened or the duration, or something else, [...] so if I'm going to look at it [...] it's for a purpose [...] is there some form of information we need."

The idea that the value of viewing images is case specific and for a particular purpose is also reflected in this participant's comments that their working relationship with law enforcement officers engaged in joint investigations improved after officers understood and accepted that it is not always necessary for a CP worker to see the images: "at least there's a dialogue now, between myself and officers that I've worked on that with, that I ... opt not to, and if I don't want to it's okay [...] and I'm not getting any kind of flak for opting not to" (Group 11, P7). Another participant agreed there was a time when law enforcement would give CP workers "flak" for not wanting to view images: "these are really difficult images for us to see, especially after we've just interviewed the child, and now ... we're seeing the abuse live, so a lot of times with the officers that I've worked with [...] it's not a given anymore that I want to see those images, so, a lot of times I'll just use my discretion and opt not to see them" (Group 11, P2).

One participant noted that for CP workers to be able to do CSAIO work, it is important to "give permission for people to say [...]/ don't feel I'm equipped to manage the situation, even though I've been involved with this family for the last five years, and that that be okay and not seen as, well you know, you're a trained child protection worker and therefore you should be able to deal with this" (Group 11, P5).

Several ICE participants referred to the difficulty of meeting victims whose images they have seen: "if you're analyzing images, video, there's that [...] compartmentalization [...] this is just images not necessarily a person, right, that's how you're gonna disassociate what's going on, right, so if you meet that victim ... um, yep, uh, no, uh ... I'll stay in my box" (Group 3, P4). One said, "I had a really hard time looking at her actually because all I could see was her being molested" (Group 3, P2). Such comments convey how hard it is to "stay in my box" when you meet a victim, which further reflects sensitivity to how difficult viewing CSAIO would be for someone doing ongoing support work with that child.

C. "We could help them understand one way or another." Some CP participants discussed the need to incorporate guidance on using personal discretion into training: "how do you actually take care of yourself, how do you recognize when you need to say I don't need to see this for my role, I think it's important to incorporate that into that training as well" (Group 11, PI). This kind of comment reflects the training CP and CMH professionals receive in self-care, and their concerns that working with CSAIO would affect their ability to manage self-care. Similarly, one CYAC supervisor described the need to know which CP workers in an organization are better able to handle exposure to images in cases where it would be beneficial, commenting that their organization "would have assigned workers and they would come in and they would view those images so that they could have a very good understanding of what this case is about [...] you really need to know who your people are so that you're not causing vicarious trauma with people that maybe can't handle those images" (Group 12, P3).

Some ICE participants speculated that there might be value in describing the content of images to CMH practitioners, without actually showing them the images: "When we identify a child and there are pictures taken of that child I think it would be beneficial to have a conversation or a meeting with whoever the therapist is for that child, to give them an idea specifically of the nature of that series" (Group 1, P2); "The stuff that we see, not necessarily that they'd have to see it, but that we could help them understand one way or another" (Group 3, P6). However, in answering our question about what they wanted to learn from other sectors, participants in CMH groups did not mention receiving detailed information contained in CSAIO.

DISCUSSION AND IMPLICATIONS

Together, the above findings describe a complex relationship between the three sectors in our study. Because of their specific role in investigating CSAIO crimes and identifying victims, ICE participants have the most extensive experience viewing CSAIO, and consequently the most specific knowledge of the abuse contained in those images. The capacity to actually see a recording of a child's abuse raises significant unresolved questions about when and whether exposure to these images, or even the detailed information contained in them, is beneficial to the professional role that participants in the other sectors play in the handling of an investigation or the support of a child victim. Given strong moral and emotional aversion to viewing CSAIO, and the potential negative impact of viewing them on professionals, much care needs to be given to establishing principled guidelines for when, how, and if CSAIO is shared among professionals working in this field.

The advent of digital recording and communication technologies has resulted in ICE participants dealing with unprecedented exposure to documentary evidence of CSA. Our ICE participants felt that they had a lot of information to offer to professionals in other sectors who work with victims. However, each profession has a different orientation to the details of a child's abuse, and what is useful for law enforcement may not be useful for CP and CMH. It is well established that different professions have different ways of looking at the same situation based on the roles and responsibilities of their disciplines and the way they are trained (Charles and Alexander 2014; Charles, Bainbridge, and Gilbert 2010). For law enforcement, details are important evidence. For CP, details may or may not be important, depending on what they mean to the determination of whether the child needs to be protected or otherwise separated from a parent or caregiver. For CMH, details usually come from the client at the client's pace, and the level of detail that is useful is determined both by the treatment approach and the client's needs. In other words, it is not universally the case that more detailed information about a child's abuse, such as that graphically depicted in CSAIO, is necessary or even helpful to the services CP and CMH provide to victims.

To the extent that some of this information is useful to CP investigations or to CMH supporting a child victim, further questions regarding how to share that detailed information arise and also require further investigation. While a few CP participants who had viewed CSAIO related to specific cases stated that doing so can serve a purpose in their investigations, it remains unclear whether the same benefit could be achieved via a narrative description of the contents of the images. The same questions apply to CMH, where information about the grooming process, for instance, may be conveyed via narrative description. Further study of whether there is a qualitative difference in capacity to support clients when practitioners have detailed knowledge of the client's abuse experience, and what difference it makes how that knowledge was acquired, is needed. Once we have a better understanding of what degree of detail is appropriate to the role of each professional, then finding ways to facilitate this knowledge exchange will also be required.

The practice of showing CSAIO images in training contexts raises related issues about the need for a clear purpose for showing an image. The CP participant who defended the practice echoed comments by some ICE participants who felt that viewing CSAIO was crucial to understanding the severity of the harms done to the children in the images. The belief that misconceptions about the true nature of CSAIO can be effectively dispelled by showing examples runs the risk of backfiring, as some other CP and CMH participants said they felt being shown an explicit image was not necessary and instead made them reluctant to attend trainings for fear of exposure to further images. If the purpose of viewing CSAIO is not clearly of benefit to the professional's role or to the specific child pictured, then being shown an example of CSAIO in training does not contribute to the balance of doing "more benefit than harm" that ICE participants conveyed. Further, CP and CMH participants who discussed having seen an example of CSAIO in training did not mention that exposure as having translated into any useful practice applications. Our findings related to the effectiveness of training will be examined in a further paper from this study.

The ethics of showing examples of CSAIO in trainings also strongly calls for consideration of the rights of the children depicted in the images. While victims' fear of exposure via CSAIO creates a significant additional barrier to disclosure of abuse, further study is needed as to whether particular victims, once they become adults capable of consent, feel some benefit from allowing an image in which they are featured to be used for training purposes, for instance as a means to support professionals that help other children. Such a study would need to inquire into what sorts of training purposes would produce that beneficial result, and further what sorts of images a victim might consent to being shown (e.g., explicit images, or images that only portray the context of abuse to accompany a narrative). Without this connection to a benefit to the victim pictured, it is doubtful that showing CSAIO in training contexts outside of law enforcement is ever justified.

That being said, we do need to take the broader cultural tendency to minimize or soften the nature and magnitude of the problem of CSAIO seriously, and acknowledge the special position held by ICE, who have unique insight into the phenomenon. While concern for the well-being of CP and CMH professionals is crucial, so too is the available evidence that the well-being of ICE officers depends in part on their sense of doing important and effective work. The feeling that others do not understand how important this work is informs the desire to shock others into recognizing it, even as most ICE participants expressed sensitivity to the need to protect victims from unnecessary further exposure.

Professionals in all sectors referred to feeling judged (either for doing ICE work or not wanting to see images). Feeling judged speaks to the difficulties with this line of work, where strong moral norms speak against willingness to be exposed to CSAIO, even when it is "for the greater good." CP and CMH participants focused on trust and respect between sectors, including with regard to when showing images serves a valid purpose and when it does not. The building of trust and respect between professions can be a time consuming and fragile process, but as can be seen from our findings, it is essential to the decrease of barriers.

CONCLUSION

It is clear that an effective response to CSAIO requires strong collaboration across law enforcement, CP, and CMH. This collaboration will be dependent in part upon agreement on what is needed by each profession in terms of training, and determining when viewing CSAIO or otherwise obtaining information contained in images is ethical or beneficial in handling specific cases. This clearly involves coming to consensus on whether the exposure to viewing CSAIO should be included in training. This is not a simple discussion. It is fraught with worldview differences between the sectors. It is critical that this be a planned process that purposefully explores what each profession needs to fulfill its functions in both investigations and in providing protection and support to child victims. Policy development and training has to be profession specific and role sensitive as well as crossdisciplinary in a manner that brings people together to deal with an issue so important to the well-being of exploited children.

ANDREA SLANE

University of Ontario Institute of Technology

JENNIFER MARTIN

Ryerson University

JONAH R. RIMER

Oxford University

ANGELA W. EKE

Ontario Provincial Police

ROBERTA SINCLAIR

Royal Canadian Mounted Police

GRANT CHARLES

University of British Columbia

ETHEL QUAYLE

University of Edinburgh

The authors gratefully acknowledge the excellent research assistance provided by Jin Lee and Hillary Walker, and Linn Clark's indispensable editorial support. This study was funded by the Social Science and Humanities Research Council of Canada.

Andrea Slane, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, 2000 Simcoe St. N., Oshawa, Ontario L1H 7K4, Canada. E-mail: [email protected]

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Legislation

Canadian Criminal Code, [1985] RSC 1985, c. C-46.