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Self Care & The WorkPlace

Self-care is very important. After reading through other classmate’s self-care posts I decided to do a deeper dive into Self-care and trauma. Self-care is important in order for individuals to perform their best at work. The article Embedding Staff Self-Care into The MTSS Framework for Those Working in Correctional Facilities looks to integrate self-care practices into a workplace for staff that pours their heart and soul into caring for juveniles and keeping them safe (Jolivette et al, 2019). These staff members are experiencing trauma through the juveniles they work with and them helping the juveniles expose them second-hand to traumatic experiences.

Self-care can help prevent  burnout and alleviate some stress (Jolivette, 2019). Employer benefits that help support self-care that were mentioned in the article are gift certificates for the most amount of steps walked, access to recreational equipment and discounted gym memberships (Jolivette, 2019). All of these are a nice perk in a workplace but can be used as self-care because every job can be a little stressful and you don’t want to burnout. 

Works Cited:

Jolivette, K., Swoszowski, N., Kumm, S., Sanders, S., & Ansley, B. (2019). Embedding Staff Self-Care into the MTSS Framework for Those Working in Juvenile Correctional Facilities. Journal of Correctional Education (1974-), 70(1), 2-19. Retrieved June 22, 2021, from https://www.jstor.org/stable/26864119

Mindfulness as an Exercise

Mindfulness is a form of therapy used for anyone who wants and needs to understand their surroundings and how to mentally accept it. Practicing mindfulness improves depression and emotional regulation through detachment, changing not thoughts and feelings but the person's relationship to them” (Bateman, 2012). The process of mindfulness includes closing your eyes, focusing on each breath you inhale and exhale, and trying to keep your focus on your breath and not distractions. A favorite exercise in mindfulness is to imagine a creek of water with leaves floating downstream, one by one. While imagining flowers, green grass and a hillside as the backdrop, imagine the sounds of running water and begin to focus on each leaf as it was swept away. The patient is then advised to put a "thought", any thought, on each leaf as it floats away in an effort to clear the mind and feel some relief. By focusing on those leaves, the goal is to take notice of any distractions and then force your attention back to the leaves. The most important phrases in mindfulness is "notice that" and "what´s next"? (Van Der Kolk, 2015) Living in the moment is the key to this therapy.

Trauma leaves victims with feelings of unbearable sensations (2015) and mindfulness allows us to understand body awareness. When a person feels agitated, other similar emotions may arise but when you are aware of that pattern, you have more control over suppressing it and exerting that energy in a different way (2015).

Mindfulness stems from Buddhism – “to alleviate suffering and cultivate compassion” (Ludwig & Kabat-Zinn, 2008). This can include a decreased perception of pain, the ability to tolerate pain, and the enhanced ability to reflect on choices (2008). Mindfulness can be extremely effective for those who need to realize their attachment to certain feelings and emotions so they can change their relationship with it, not their thoughts and feelings (2012).

Research from Britta Holzel and Sara Lazar "has shown that practicing mindfulness even decreases the activity of the brains smoke detector, the amygdala, and thus decreases reactivity to potential triggers" (2015).

References

Bateman, A. (2012). Mindfulness. British Journal of Psychiatry, 201(4), 297-297. doi:10.1192/bjp.bp.111.098871

Ludwig DS, Kabat-Zinn J. (2008). Mindfulness in Medicine. JAMA. 2008;300(11):1350–1352.   doi:10.1001/jama.300.11.1350

Van Der Kolk, B. (2015). The body keeps the score: brain, mind and body in the healing of trauma. Penguin Books.

Secondary Trauma: Spouses and Couples of Law Enforcement

Police officers endures highly pressured incidents on a regular basis during their routine. For example, “a sudden death in the line of duty, serious injury from an officer-involved shooting, exposure to intense trauma on a call, a physical or psychological threat to the safety or well-being of an individual or community, regardless of the type of incident.” (Rousseau, 2021). Moreover, as explained in the incident involves any situation or event faced by police officers that causes a distressing, dramatic, or profound change or disruption in their physical. (Rousseau, 2021). Trauma can not only affect the officer themselves, but it can also impact those around them. For example, during daily routines an officer with a heightened sense and trauma may be triggered during an encounter, arrest, or stop and have the trauma affect their decision making. Such decision making can escalate encounters that did not need to result to in excessive or deadly force. There are multiple signs that may attribute to trauma that is fatigue, difficulty breathing, confusion, poor decisions, poor concentration, anxiety and much more. Therefore, it is hard for others to pick up the sense that an individual has encountered a life changing event and may be suffering from it. Specifically, it may be hard for a spouse or significant other to pick up that their loved on is suffering from trauma, especially if they have a career in law enforcement.

Photo by: Police life

            Although many research suggests that law enforcement professionals (LEP) are directly affected by trauma, few have focused their attention on the secondary trauma of their loved ones or spouses. A study was conducted, where an in-depth qualitative interview on eight spouse of law enforcement. In a summary, the results had shown that trauma creates a domino effect onto the spouse, however, the upside to this is that it appears that such couples show a strong bond and how they cope with the trauma.

            As stated, police officers encounter crime, violence, and life-threatening events on a daily basis. Because of the dramatic exposure such exposure can impact an LE spouse or family. “The investigations that have focused on LE spouses suggest that police work has a detrimental impact on LE spouses and that those in close contact with the traumatized person also experience symptoms of traumatization.” (Landers et. Al., 2020). “Family support is critical for reducing the negative impact” of stressful work in the criminal justice profession. (Landers et. Al., 2020). Moreover, it is noted that family members play a role to support their partner that is in the LE career. Such role may include, but not limited to, additional responsibilities, creating coping mechanisms, social support, and developing a great way to communicate. Interesting, it is encouraged for spouses and family members to be quite involved because the high prevalence of trauma and the idea that the spouse can help assist clinicians to better understand how trauma affects the couple relationship and how to reduce its negative impact. (Landers et. Al., 2020). However, secondary trauma is described as a natural consequence of behaviors and emotions resulting “from knowing about a traumatizing event experienced by a significant other-the stress resulting from helping or want to help a traumatized or suffering person.” (Landers et. Al., 2020). However, when a spouse wants to help their significant, they may to subject themselves to the secondary exposure to trauma. The reason for this is because family members influence the quality of family relationships. Spouses endure the challenges that’s comes with a significant other that works in a highly stressful profession. Behind closed doors, spouses are the ones that see their professional spouse through it all, mental breaks downs, anxiety, distancing and much more.

In a study, interviews of LAE spouses all had to think of an occasion when they had noticed their partner is going through a traumatic event and how it directly affected them. At the end of the study, it was shown that partners are exposed through many different types of traumas i.e. death, injury etc. However, it was also noticed that such trauma may cause a ripple effect as in the LE may begin to have mood swings, changes in behavior and that may affect the spouse. For example, one spouse stated that they fear every time their spouse goes to work and other states that if their LE doesn’t scan the room, then it feels as if she does because she adapted a sense of insecurity. But because of such issues and the domino effect of trauma, spouses have developed a sense to cope.

Coping mechanisms has allowed for spouses to develop better coping mechanism and provide mutual support by understanding each other’s position. For example, “if something bad happens, we get really cohesive.” (Landers et. Al., 2020). Open communication about the traumatic event exposure and the pressure of the trauma appears to be a very important coping mechanisms for a couple’s relationship. By tackling on LE family or spousal health it illuminates the importance of the supportive role that they play.

Landers, A. L., Dimitropoulos, G., Mendenhall, T. J., Kennedy, A., & Zemanek, L. (2020).Backing the Blue: Trauma in Law Enforcement Spouses and Couples.Family Relations, 69(2), 308-319. https://ezproxy.bu.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fbacking-blue-trauma-law-enforcement-spouses%2Fdocview%2F2376234440%2Fse-2%3Faccountid%3D9676

Rousseau, D. (2021). Module 6: Trauma and the Criminal Justice System. Boston University Metropolitan College: Blackboard.

EMDR as Trauma Therapy

Currently, there are many different techniques that people can use to alleviate issues they are experiencing due to a traumatic event. Sometimes it can be overwhelming when you are already experiencing negative emotions from the trauma you’ve faced and now you are trying to seek help, but might not know where to start. I believe that Eye Movement Desensitization and Reprocessing (EMDR) therapy is a very beneficial technique that can be added to your regular therapy session. EMDR has been proven to alleviate stress and negative emotions associated with traumatic events (One80center, 2012). To help you better understand EMDR and its benefits, first let me explain what EMDR is.

EMDR therapy is a psychotherapy approach to trauma treatment that uses a series of bilateral stimulation, most common being eye movements, during regular therapy sessions. There are eight phases total in the EMDR process which consist of history, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation (Rousseau, 2021). During the history phase, they discuss both past and present concerns and what they want in the future. They do this to identify and target the traumatic events that they need to process. In the preparation phase, the therapist and client identify a safe place for when the client experiences distress and they have to want to regain self control and a sense of stability (Rousseau, 2021). In the assessment phase, the therapist has the client start to recall the traumatic events while also identifying the negative views and beliefs they have about themselves because of the traumatic event. In the desensitization phase, the clients are now exposed to a series of eye movements or even clicks while they recall the traumatic events. This is supposed to help them reprocess the events (Rousseau, 2021). In the Installation phase they continue the same eye movement mixed in with regular therapy, but this time they are getting the client to focus on the positive beliefs about themselves in relation to the events. After this phase, they conduct a body scan to evaluate if the clients progress and to see if they need more sessions. As for the closure and reevaluation phases, these phases are conducted in every session. Revaluation phase/ process is done in the beginning of every session to see if the client needs to complete a desensitization or installation phase and closure phase/ process is completed at the end of each session so that they can review and it allows the clients gain a sense of safety/ control before leaving the session (Rousseau, 2021).

You might be saying okay I understand the phases, but how does EMDR work exactly? Dr. Andrew  M. Leeds, the author of A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants and who has also used EMDR in his therapy sessions since 1991, explains in an interview on all the current working hypotheses of EMDR, why EMDR is so effective. Dr. Leed brought up the REM, rapid eye movement or orienting response hypothesis as an explanation (One80center, 2012). The REM, rapid eye movement, or orienting response hypothesis has two parts. The first part discusses REM sleep. During REM sleep we lose the vividness of emotions and feelings in the memories we have and we only store the important information instead. This is combined with the second part, in which a therapist brings up the memories while also triggering the client’s orienting response by using rapid eye movement, allowing the client to associate the original stress and emotions from the situation as something from the past and less vivid, which makes the part of the brain that perceives the emotional parts of the event see it as boring stimuli, and then it is moved to the REM system. When they are  moved to the REM system, the memories are stored as less vivid and intense. This in turns helps the client move past their traumatic experiences (One80center, 2012). 

Though EMDR is commonly used for PTSD patients, EMDR has also been proven to work for many other stress disorders. In an article where they analyzed seven different studies that used EMDR therapy with cancer patients, 140 patients in total, they found that EMDR had lowered the stress levels of the patients and improved their overall quality of life (Portigliatti Pomeri, La Salvia,Carletto, Oliva, & Ostacoli., 2020). It was stated that this occurred due to the EMDR therapy alleviating the psychological stress that the patients were experiencing (Portigliatti Pomeri, La Salvia,Carletto, Oliva, & Ostacoli., 2020). 

Though everyone who experiences a traumatic event has a different response, I believe that EMDR is an effective tool that can help alleviate the stress and tiggers that come from the traumatic event. Over all, EMDR has been proven to be a great tool for those who have experienced traumatic events. With EMDR being effective for not only PTSD, but also other stress disorders, I believe that it should be used in regular therapy sessions more frequently. If you would like to see EMDR in practice or get more information check out the Lukin Center youtube page linked below! 

Sources: 

Portigliatti Pomeri, A., La Salvia, A., Carletto, S., Oliva, F., & Ostacoli, L. (2020). EMDR in Cancer Patients: A Systematic Review. Frontiers in Psychology, 11, 590204–590204. https://doi.org/10.3389/fpsyg.2020.590204

One80center (September 6th, 2012). Q5: Can you tell us why EMDR works?- EMDR with Dr. Andrew M. Leeds Ph.D.- ONE80CENTER

https://www.youtube.com/watch?v=sWyDWvMEl1E 

The Lukin Center (2021, March 9). EMDR Therapy: Demonstration & Step-by-Step Walkthrough. [youtube]. https://www.youtube.com/watch?v=M2ra8p4MSOk 

Rousseau, D. (2021).Pathways to Recovery: Understanding Approaches to Trauma Treatment. [virtual lecture]. https://onlinecampus.bu.edu/ultra/courses/_75565_1/cl/outline

Politics and Policing

On January 6, 2021, several thousand supporters of former President Donald Trump gathered at the White House in attempt to overturn his loss in the 2020 Presidential Election to now President Joseph Biden. As a result, approximately 8,000 protesters stormed the Nation’s Capital in which the protesters condemned, vandalized, and looted. The US Capitol what is supposed to be one of the most secured facilities within our country was overtaken. The last time such a cataphoric event occurred was on August 24, 1812 during the war of 1812 between the United States and Great Britain when the White House was overtaken. Sadly, this feat which seemed unimaginable somehow occurred again, and this time by those who shamefully call themselves Americans.

On January 3, 2021 the information regarding this planned protest was provided to former Capitol Police Chief Steve Sund. Due to the possibility of the protest to turn to violent, which has been a trend in our country during 2020, Sund requested the National Guards assistance. Sund’s request was not approved by the Sergeant at Arms of the houses of Congress and Pentagon officials. According to the Post, Sund’s request was denied because officials were concerned about the visual of armed soldiers standing by police (Staff et al., 2021). The poor leadership ability exercised later caused destruction of the Capitol, death of civilians and police officers.

According to Merriam-Webster Dictionary, optics can be defined as the aspects of an action, policy, or decision (as in politics or business) that relate to public perceptions (Merriam-Webster). Throughout 2020, our country has seen a disgusting increased in concerns of optics demonstrated by law enforcement agencies. Mostly, these optics are not the fault of the men and women on the front lines, or command staff level administrators, but rather public government officials. This increased in concern of optics has led to further violence, death, destruction of communities, and significant trauma on officers.

Throughout 2020, police stations, precincts, and communities were frequently being burned to the ground by so called “peaceful protesters”. This destruction was not wanted by police nor those who reside in the communities. The lack of leadership of local government official’s negligence to take a stand negatively impacted those who they are elected to serve.  For example, this was demonstrated in Seattle, Washington when the autonomous zone was created. According to CNN pertaining to Seattle Washington, “The Seattle police chief is openly criticizing city leaders for evacuating the Third Precinct building in the city's Capitol Hill district. "You should know, leaving the precinct was not my decision," Police Chief Carmen Best said in a video addressed to the members of the department. Chief Best added that the city "had other plans for the building and relented to severe public pressure," and expressed her anger at how all this came about. She said officers spent days protecting the building before the city boarded it up (Andone,2020). Due to the poor leadership in the Seattle, the law-abiding citizens within the autonomous zone were not able to be provided to proper law and order which they are entitled to.   Seattle and the Capitol breach both demonstrate where those in position of power in public safety organizations lost the purpose of public safety, which is law and order.

Poor decisions made by command staff level and elected officials directly affect the mental well-being of those that serve under them. In this instance, the elected officials declined to activate the national guard and additional police because they were too concerned with the image of armed officers and soldiers. Not to mention, the elected officials were aware of the potential threat and they put their political agenda above the officer’s safety and American citizens safety.  Poor decision making directly affect the morale and trust officers have in their administration and ultimately their well-being. As a result of these decisions an officer was killed turning this catastrophic event into further trauma for those involved. The lack of proper management skills by elected officials will live with officers mentally and potentially cause PTSD.  Furthermore, instances like this create the do more with less mentality, lack of sufficient manpower for protests, which already cause a great deal of stress for officers.

References:

Andone, D. (2020, June 12). Seattle police want to return to vacated precinct in what protesters call an 'autonomous zone'. Retrieved June 20, 2021, from https://www.cnn.com/2020/06/11/us/seattle-police-autonomous-zone/index.html

Optics. (n.d.). Retrieved June 20, 2021 from https://www.merriam-webster.com/dictionary/optics

Staff, T. C. R., Chew, C. M., & James M. Hingeley and Gregory D. Underwood. (2021, June 20) Officials Feared 'Optics' of Deploying National Guard at Capitol Before Riot. The Crime Report. https://thecrimereport.org/2021/01/11/1189176/.

Treating vs. Curing

When trauma is commonly thought of most would expect that it results from war or other instances involving numerous encounters of overwhelming stress. Although these instances certainly pose a significant risk of trauma, trauma can be more easily obtained by numerous different types of events and is encountered frequently on a regular basis. About 6 out of every 10 males and 5 out of every 10 females will face trauma at least once some point in their lives (National Center for PTSD). In addition to that, about 7 to 8 percent of the population will have posttraumatic stress disorder (PTSD) at some point during their lives (National Center for PTSD). Trauma is defined as “an emotional response to a terrible event like an accident, rape or natural disaster.”  (American Psychological Association). Due to the ability of trauma to affect so many people not only in the U.S. but worldwide it is important to understand neurobiology and the effects such events have on the brain. Understanding the neurobiology of trauma is a must for treating such trauma medically and will aid in teaching coping methods to those suffering from these traumatic events. With that being said, the developed understanding of the neurology seems to successfully identify the parts of the brain that are stimulated and associated to disorders relating to trauma yet medicine fails to permanently cure the issue and only keeps those under balance while on the medication. Considering that a lack of medicine can leave one defenseless if not taken or forgotten should medicine be an approved or considered a reliable form of treatment to trauma?

“When someone experiences a traumatic event or experiences extreme fear, brain chemistry is altered and the brain begins to function differently--this is called the "Fear Circuity" and it is a protective mechanism which we all have inside of us.” (University of Northern Colorado). Knowing that a traumatic event can alter the brains chemistry leaves an open door within neurobiology to examine and treat the lasting effects. “Sertraline and paroxetine are the only antidepressants approved by the FDA for the treatment of PTSD” (Alexander, 2012). To this date there is no known permanent treatment of PTSD by prescription drugs and all are needed to be taken regularly and prescribed a dosage. Medications work by altering neurotransmitter production and transmission (Rousseau, 2021). However, other methods like yoga “can help to redirect the firing of neurons, or even create new neurons through two processes, called neuroplasticity and neurogenesis.” (Rousseau, 2021). Suicide rates of those dealing with PTSD is as much as thirteen times as many as those not dealing with PTSD (Gradus, 2017). Since a medical form of treatment cannot be relied on if they are not obtainable at all times it poses a clear significant risk to those dealing with PTSD. As pointed out in the film “Healing a Soldier’s Heart” there have been over 110,000 suicides since the Vietnam war which is almost twice as many casualties during the war of 58,000 (Healing a Soldier’s Heart, 2013). With this in mind, unless a more sustainable one time treatment becomes an option, teaching coping techniques should be more of a recommended form of treatment.

Of course there are extreme cases where teaching coping methods are not sufficient enough and the use of medication is needed to support the healing process. The message here is not to discredit current medications but to raise the concerns on its reliability and support future alternative methods that provides more of a cure than a temporary fix.

Works Cited

Alexander, W. (2012, January). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/

Gradus, J. (2017). PTSD and Death from Suicide. Retrieved from https://www.ptsd.va.gov/publications/rq_docs/V28N4.pdf

Neurobiology of Trauma. (n.d.). Retrieved from https://www.unco.edu/assault-survivors-advocacy-program/learn_more/neurobiology_of_trauma.aspx

Olsson Stephen, & Cultural & Educational Media (Producers), & Stephen, O. (Director). (2013). Healing a Soldier's Heart. [Video/DVD] The Video Project. https://video.alexanderstreet.com/watch/healing-a-soldier-s-heart

Rousseau, D. (2021). CJ 720 Module 1. Boston University. https://learn.bu.edu/ultra/courses/_75565_1/cl/outline

Trauma and Shock. (n.d.). Retrieved from https://www.apa.org/topics/trauma

VA.gov: Veterans Affairs. (2018, September 13). Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp

Restitution and Victims of Child Exploitation

Years ago, while working as an analyst processing evidence in child exploitation cases, I met a victim of one of the most widely circulated child pornography series to date. While the abuse occurred when the victim was ten and eleven, I met her right before she started college, after her fugitive father was arrested and finally prosecuted for his crimes. She recounted how the abuse was traumatizing enough, but later discovering her father traded images and videos of the abuse online was almost too much to bear. She also discussed the long-term implications from that knowledge, fearful that every person she encountered might recognize her from those images of the worst moments of her life. Knowing that so many individuals took pleasure in her pain was also something she couldn’t comprehend. Meeting her was surreal, as I viewed images of her abuse in nearly every case I examined, and I could not even fathom what she had experienced in her young life. This encounter was almost 15 years ago, and it still has a great impact on me, and I am devastated for her (and all victims of this sort of crime) that those images are probably still being circulated every day, with the victim never being able to escape the daily reminder of the abuse.

Although I am no longer certain if this is the norm, when I worked in that field, it was a requirement that the identified victim of child exploitation be notified every time their image appeared in a case, with some victims potentially notified multiple times a day, every day of the week, due to the frequency their images were traded. While I understand the intent behind this requirement, in reality, it meant the victim faced a constant reminder of the abuse, impeding their ability to move forward. Due to this reason, some of the victims assigned an intermediary to receive the notifications, as they could not handle the constant influx of notices.

Assisting victims of crime and trauma is a challenging situation, as there is no way to erase the impact of what happened to them. “Trauma impacts the individual, his or her relationship with family and friends, his or her ability to hold jobs, and the way he or she interact with the world around him or her. It can change life paths, alter personal abilities, and cause physical and neurological damage that may or may not be repaired” (Rousseau, 2021, p. 8). Every person handles trauma differently, and every case is different, with some offenders penalized to the maximum extent of the law, while others get no penalty. The concept of restitution continues to be brought up when discussing victims of crime, although there are advocates both for and against employing monetary compensation for crime victims. "Restitution means restoring someone to the position occupied before a particular event took place,” while the “purpose of restitution is to make a victim whole” (Boe, 2010, p. 210). Forcing an offender “to pay a monetary fine, often in addition to serving a prison sentence, forces an individual defendant to address the harm his crime has caused to the individual victims of his crime and to society. Victims, especially victims of child pornography, frequently suffer both financial and emotional losses because they have to seek counseling or medical services for the rest of their lives” (Boe, 2010, p. 211). While money will never make a crime victim “whole” again, and will never be able to “restore” them to the person they were prior to the traumatic event, monetary compensation can help alleviate some of the financial hurdles they may face with seeking treatment or account for some of the financial losses they may have incurred due to their trauma.

However, one challenge surrounding restitution is assigning a financial sum commensurate to the impact on the victim, which is seemingly impossible, as the full impact can never fully be accounted. “Knowing that thousands of individuals possess images and video of oneself being raped and sexually abused in humiliating fashion can inflict deep, life-lasting trauma that extends well beyond the initial sexual abuse. This emotional trauma results in economic burdens,” including psychological counseling costs and lost income (Cassell et al., 2013, p. 73). Additionally, “determining each victim's losses requires a careful analysis of how each victim's life is impacted by child pornography,” which includes economic, emotional and physical losses, with restitution payments providing “not only psychological counseling, but also vocational and educational training to move forward with their lives” (Cassell et al., 2013, p. 74).

While I don’t have any concrete ideas regarding a “just” way to compensate various victims of crime, I do think some sort of financial reimbursement is warranted to cover some of the long-term medical, legal and therapeutic expenses, which can accumulate quickly. An additional challenge also arises when trying to recoup money for the crime victim, especially if the offender has no financial means to repay the victim. A victims’ compensation fund has been discussed, as have many other ideas, but the practical enforcement of restitution might also impact a victim long-term, if they are additionally traumatized by the justice system. Overall, I find the idea of restitution a fascinating and relevant topic concerning crime victims and the impact of trauma, although there is no easy solution when figuring out how to implement it. For me, meeting the victim was a huge reminder that we never know what anyone else has gone through or is currently going through, as looking at her on the surface, no one would have ever guessed what she was battling under the surface. Overall, it reminded me that when discussing some of these issues regarding restitution, or punishment or rehabilitation, a real-life victim is on the other end, and the human impact element is always the one that needs top consideration.


References

Boe, A. B. (2010). Putting price on child porn: Requiring defendants who possess child pornography images to pay restitution to child                     pornography victims. North Dakota Law Review, 86(1), 205-230.

Cassell, P. G., Marsha, J. R., and Christiansen, J. M. (2013). The Case for Full Restitution for Child Pornography Victims. George                            Washington Law Review, 82(61), 61-110.

Rousseau, D. (2021). Module 1 Study Guide [Notes]. Boston University Metropolitan College.