Exiting Prostitution

A Study in Female Desistance

R. Matthews, Helen Easton, Lisa Young, Julie Bindel

• Publisher: Palgrave Macmillan
• Year: 2014
• Print ISBN: 9781137289414
• eBook ISBN: 9781137289421
• Topic: Politics & International Relations
• Subtopic: Ethics & Moral Philosophy
• Index: Politics & International Relations

How people move from deviant to conventional lifestyles is an issue that has attracted considerable interest over the past few years. However, much of this work has focused on men desisting from crime. This book provides one of the first examinations of desistance which is centred on women and, more specifically, how they exit prostitution.

1

The Dynamics of Exiting and Desistance

Introduction

There has been a considerable amount written about women’s entry into prostitution but relatively little about how they exit. Over the past decade, however, there has been growing interest in the exiting process. This interest has been stimulated on one hand by a steady stream of sociological and criminological literature on desistance and on the other by the growing realisation that a large percentage of women involved in prostitution would like to exit if they could (Audet and Carrier 2006; Bradford 2005; Farley 2004; Hough and Rice 2008; Ng and Venticich 2006; O’Neill and Campbell 2011).

It has been found in various studies that few women see prostitution as a long-term ‘career’ but that most aim to be involved for a limited period of time, either to deal with financial or personal issues, or to finance drug habits. Some women take breaks from prostitution to take up ‘formal’ employment for certain periods and return to prostitution at a later date (Melrose et al. 1999). Significantly, a recent review of trends in Glasgow found that in the late 1990s that there were an estimated 1,100 women involved in street prostitution and that by 2010 the number had decreased to approximately 250 (Matthews and Easton 2011; McKeganey 2005). This dramatic decrease serves as a salient reminder that women do leave prostitution over time in considerable numbers, and that in some cases they leave with a minimal amount of formal intervention.

In contrast, the successful removal of prostitution from the streets of Ipswich following the murders of five women in December 2006 involved the implementation of a coordinated multi-agency intervention (Poland et al. 2008). The key to this success was, on one hand, the provision of an integrated and comprehensive set of services that linked exiting to prevention work, while tackling demand; and on the other, the adoption of a multi-agency case conference approach for each of the women involved in street prostitution. This type of individualised case management approach has also been adopted to some extent in Manchester, Leeds and Glasgow. The aim is to develop a care plan and personalised programme that can engage with the women on a one-to-one basis and facilitate exiting. What is also significant about the exiting programmes that have been developed in these locations is that they all challenge the view that prostitution is here to stay and believe that a substantial reduction in the level of prostitution is not only desirable but also possible (Lawrence 2007; Manchester Prostitution Strategy 2007; Matthews and Easton 2011; Scottish Executive 2004; Ward 2007).

Explaining desistance

Desistance is usually defined as the end of a period of involvement in addictive or deviant behaviour. However, it is always possible that those who have overcome addictions or stopped offending for a period may return at a later date. Consequently, it is always uncertain whether individuals have actually desisted or just stopped engaging in an activity for the period under consideration (Maruna 2001). Thus, although there is always a degree of arbitrariness involved in defining forms of desistance, for our purposes ‘stopping’ is defined as ceasing involvement in prostitution for up to three months, while ‘exiting’ refers to those women who have ceased their involvement in prostitution for at least three months. Normally, the process of exiting is seen to involve the construction of a post-prostitution identity and the adoption of an ex-role.

For the most part, studies to date have operated with a zero-sum conception of exiting. That is, an assessment is made of whether women are still involved in prostitution or whether they have ceased involvement altogether. However, many women will for one reason or another reduce their involvement in prostitution over time. It is important to find out, however, whether this reduction is linked to efforts to exit or not. By the same token, developing strategies to facilitate exiting based solely on the final state of termination is unlikely to fully illuminate this complex process (Kanzemain 2007).

The growing focus on desistance has drawn attention to the issue of how people make radical changes in lifestyle over time and how they overcome various forms of addiction or cease their involvement in certain forms of behaviour. Among the most influential contributors to the literature on desistance has been the work of Sampson and Laub (1993). Adopting a form of longitudinal analysis, they have sought to identify the main factors that underpin significant changes in the life-course and suggest that gaining employment or entering a marriage or other stable relationship are amongst the most significant events that can affect desistance. Importantly, they argue that many of the classic predictors of onset and frequency of offending do not explain desistance. They also note that groups such as drug users do not follow the usual ‘routes out’. Desistance, they suggest, is a process rather than an event and it is subject to reversals and failure. However, the causal relationship between desistance and employment and marriage has been questioned, and while it may be the case that these events are the most important factors for some groups, they may not be for certain marginalised groups, such as women involved in prostitution (Vaughan 2007).

Gender and desistance

It is evident that even amongst the limited literature on desistance the vast majority is directed towards men, particularly young men. The research that has looked at women has shown both similarities and differences in the nature of desistance for men and women. Graham and Bowling (1995), for example, found that becoming an adult (e.g. leaving home, finishing schooling or starting a family) was related to desistance for women, but the same was not true for men. Sommers et al. (1994) on the other hand found that the factors associated with female desistance from street crime were very similar to those reported in male street offenders.

Giordano et al. (2002) found that neither marital attachment nor job stability was strongly related to female desistance, although they note that the cognitive transformations made by men and women tended to be similar and that maturation was a key factor in the desistance process for both groups. McIvor et al. (2004) found that while men explained their desistance in utilitarian terms, women often alluded to the moral dimensions of their activities. Thus, it is suggested that women’s desistance has a more pronounced ‘relational’ dimension. Interestingly, McIvor et al. (2004) and her colleagues note that many of the women in their study were keen to be viewed as desisting, even if they continued to offend. Also, the authors emphasise that it is important to distinguish between attitudinal and behavioural change when thinking about desistance. Relatedly, it is suggested by Graham and Bowling (1995) that disengaging from delinquent peers, whether consciously or by chance, is a necessary condition for desistance for some women.

The focus on gender difference suggests that if the process of desistance is different for men and women there may also be differences in relation to race and class (Katz 2000; O’Neill and Campbell 2011). In a similar way, given that women involved in prostitution are not a homogenous group, there may be significant differences amongst women involved in different forms of prostitution. Sanders (2007) has raised the question of whether exiting is different for street-based women and those who work indoors. It is also the case that ‘exiting’ has a very different meaning for trafficked women, given the role of coercion and deception in relation to their involvement in prostitution (Anti-Trafficking Monitoring Group 2010).

Barriers to exiting

Although studies repeatedly indicate that a large proportion of women involved in prostitution would like to exit, there are a number of formidable obstacles that women have to confront and overcome if they plan to leave prostitution. For many commentators, dealing with drug addiction is identified as a major issue, since it is estimated that in the UK some 70–90 per cent of women who work on the streets are problematic drug users (May and Hunter 2006). In most cases the drugs of choice are heroin and crack cocaine, the latter being particularly addictive and personally and socially destructive (Bourgois 2003; Goldstein 1979).

The question has been raised, however, of the extent to which drug use and addiction precedes, or is exacerbated, by involvement in prostitution (Potterat et al. 1998). It has also been suggested that the links between drug use, prostitution and other forms of social exclusion may be overplayed (Buchanan 2004; Melrose 2007). Problematic drug use, however, is frequently found to be linked to other vulnerabilities and needs, while homelessness has been identified as a recurring issue amongst women involved in prostitution and many women report financial and health problems that can act as a barrier to exiting (Benoit and Millar 2001; Pitcher 2006).

Apart from these widely recognised obstacles, women involved in prostitution tend to refer to problems of lifestyle, boredom and above all money (Hoigard and Finstad 1992). Relatedly, women involved in prostitution tend to have low levels of skills, poor employment histories and limited social capital. Consequently, the employment opportunities that are available are often low paid menial or temporary jobs (Hough and Rice 2008). In some cases the main barrier to exiting is the pressure from coercive and abusive partners/pimps, a proportion of whom are themselves problematic drug users (Poland et al. 2008; Ward 2007). The problem of dealing with coercive and abusive partners has moved agencies in some areas to see this as a domestic violence issue and has fostered attempts to treat women involved in prostitution and their partners simultaneously (Boynton 1998; Rice 2010). According to Hoigard and Finstad (1992), underpinning these various obstacles are problems of shame, issues of identity, a sense of insecurity and the difficulties in overcoming marginalisation and stigmatisation.

Another barrier to exiting that has been identified by a number of researchers and activists in different countries is women’s involvement in the criminal justice system (Hubbard 2006; Pitcher 2006). Involvement in the criminal justice system for prostitution-related offences is seen to increase women’s vulnerability on one hand, and to make it difficult for them to gain legitimate employment, on the other. Thus there is a growing body of opinion amongst those who are trying to develop exiting programmes that soliciting for the purposes of prostitution should be decriminalised (PAAFE 2005).

What works and best practice

The interest in exiting in the UK was increased significantly by the publication of Tackling Street Prostitution: A Holistic Approach by Hester and Westmarland (2004) and the subsequent official endorsement of exiting programmes in the Home Office publication A Co-ordinated Prostitution Strategy (Home Office 2006). Hester and Westmarland (2004) have provided an evaluation of a number of exiting projects that have been established in England and Wales. In their examination, they concluded that provision needs to be holistic and integrated in order to meet the complex needs of women seeking support. They suggested that outreach is a significant prerequisite for building a sustainable working relationship with the women, while providing one-to-one support. They emphasised the need for fast-track drugs programmes and the provision of emergency accommodation where possible. Although Hester and Westmarland (2004) sought to identify ‘what works’ in relation to the exiting projects that they examined, they note that measuring change presented difficulties and that much of the exiting provision was ‘crisis driven’. Consequently, they found it difficult to attribute change to specific interventions. They note that because different projects operated with different philosophies, policies and practices and used different definitions of ‘engagement’ and ‘exiting’, it was difficult if not impossible to determine ‘what works’ with any degree of confidence.

Other evaluations of exiting projects have encountered similar problems. The evaluation of Project Respect’s Pathways Project, based in Melbourne, Australia, for example, identifies ‘success’ in terms of the number of women attending particular programmes together with statements from service users regarding the perceived benefits (Lewis and Montague 2008). However, there is little in this form of evaluation about ‘what works’ in terms of desistance or of assessing the effect of different interventions on the process of change (Christian et al. 2009). The evaluation of the Safe Exit Diversion Scheme in London, which is principally a scheme designed to divert women from the criminal justice system, found that it helped women to build more stable lives and increase their engagement with services. However, the number of women exiting prostitution in the review period was minimal and it is not clear what worked for them (Rice 2010). The author of the report also notes that while the provision of emergency accommodation is seen as a positive response to homelessness and associated vulnerability, it was reported that living in hostels with other vulnerable, marginalised and drug-dependent women can in some cases make it hard to give up prostitution and drug use.

Drawing on the work of Hester and Westmarland (2004), Mayhew and Mossman (2007) attempt to move beyond what they see as an unduly narrow focus on ‘what works’ and instead to aim to identify examples of ‘good practice’ in relation to exiting. They point out that while there are useful qualitative and quantitative components in some of the evaluations of exiting programmes, most are based on small samples and fail to identify the impact of specific interventions. Instead, Mayhew and Mossman (2007) want to examine the design and implementation of initiatives in order to determine the best practice principles for exiting. However, since exiting strategies often form part of a package, Mayhew and Mossman face the same difficulties as the ‘what works’ approach, as it is difficult to differentiate best practice examples for exiting interventions from the spectrum of general support services for women involved in prostitution. However, they summarise what they see as the best practice principles for exiting prostitution. These include:

•The provision of holistic interventions

•Facilitating choice and flexibility

•Providing a dedicated service

•Building trusting relationships

•Developing good communication to enlisting public support for exiting programmes

•Developing outreach services

•Developing local, user-friendly services for women.

Developing a ‘holistic’ approach?

One point of agreement between Hester and Westmarland (2004) and Mayhew and Mossman (2007) is an emphasis on the adoption of a ‘holistic’ approach, which is seen as necessary to provide an effective response to the complex needs of women involved in prostitution. Thus Hester and Westmarland (2004) strongly suggest that:

Holistic support, which includes a range of mechanisms of support services (outreach to engage those involved in prostitution, one-to-one work and fast track drug services), geared to the individual needs of women involved in prostitution, are more likely to result in exit from prostitution. This should be central to any approach tackling street prostitution.

(Hester and Westmarland 2004: 40)

The call for the adoption of a holistic approach has been extremely influential in the literature on exiting and a considerable number of commentators have echoed this sentiment. However, there is some uncertainty about what constitutes a holistic approach, how such an approach should be applied and what combination of policies and practices defines an approach as ‘holistic’ (Clark and Squires 2005; Colley 2003; Harcourt et al. 2005; Saphira and Oliver 2002).

The dictionary defines ‘holism’ as ‘the treatment of any subject as a totally integrated system’ and states that it involves ‘treating the whole person rather than just symptoms of a disease’. Holistic approaches are widely seen as preferable to those approaches that provide a partial, selective or an uncoordinated response. On one level, it is difficult to argue against the adoption of a holistic approach and it is widely viewed as preferable to piecemeal forms of intervention. However, the question arises about what needs are relevant to the process of exiting and how those needs are to be identified and dealt with. Clearly, all the person’s needs cannot be dealt with, and the difficulty is identifying relevant needs and prioritising certain needs over others. Often this is linked to conceptions of risk.

Our task, therefore, should not be to try to identify all the person’s needs but rather to develop a tailored and strategic approach that aims to identify those needs or risks that are associated with exiting. In this way the identification and response to needs is necessarily selective and targeted. However, identifying the needs that require attention in order to exit is far from obvious. It is not the objective of intervention to deal with the ‘whole person’ and to work on the assumption that all the person’s needs have to be addressed before they are able to exit. Thus in practice the required response provided is always likely to be less than ‘holistic’. Needs that are not linked to exiting can be dealt with, if necessary, after the person has left prostitution. Thus it would seem that there are three limitations to the practical adoption of a ‘holistic’ needs-based strategy. The first is deciding what constitutes relevant needs. The second is deciding which issues need addressing in what order if the aim is to help women leave prostitution. Third, the focus on individual attributes all too often tends to be divorced from wider social contexts.

The corollary of trying to develop a ‘holistic’ or integrated approach is the development of a coordinated multi-agency approach, in order to address the person’s multiple vulnerabilities. Again, at first sight this appears very positive and desirable. However, research has repeatedly shown the limitations of multi-agency approaches and the recurring problems of coordination (Crawford 1998). It is the case that each agency tends to have its own priorities, view of the issues, and set of practices and principles. This is likely to involve differences in perception, diagnosis and response. In effect, the different agencies rarely respond to the person as a whole but rather deal with particular issues. This leads to what Haggarty and Ericson (2000) refer to as the ‘surveillant assemblage’, which ‘separates human bodies from their territorial settings, while separating them into a series of discrete flows’. Moreover, since the identification of (relevant) needs is uncertain, it is not always clear which agencies are required and how they might be effectively coordinated. In some cases the appropriate services may not provide the type of services requested, often resulting in the adoption of a more piecemeal and selective approach than the notion of ‘holistic’ would suggest.

All too often support agencies concentrate on the vulnerabilities and problems that women face. This approach can be characterised as a ‘deficit model’. From this vantage point exiting is to be achieved by removing these ‘deficits’. It is paradoxical that many support agencies and researchers that claim they want to ‘empower’ women involved in prostitution all too often present them as little more than a bundle of unresolved needs. However, rather than adopt this largely negative deficit model, which aims to promote exiting by overcoming unmet needs and vulnerabilities, it might be more productive to simply ask the women concerned what they require in order to exit prostitution. This may involve not only focusing on their unmet needs but also on the more positive aspects of their lives. That is, rather than concentrate on their shortcomings it may be more appropriate to place more emphasis on a ‘strengths’ and ‘opportunities’ model that explores women’s interests, aspirations and capacity for change. The focus on strengths may well provide women with a positive view of their capabilities and abilities, which in turn may help them to deal with their various vulnerabilities.

Ward and his colleagues have developed a ‘strengths-based’ approach which they call ‘The Good Lives Model’ (Ward and Brown 2004; Ward and Maruna 2007). Based on the assumption that most people given the opportunity want fulfilling lives, it suggests that intervention should speak directly to women’s self-interest. The Good Lives Model aims to focus on positive change, personal development and the achievement of identified goals. Rather than using only the language of deficiency and inadequacy, it aims to construct a positive approach linked to the development of skills and competencies in order to try to achieve a more satisfying life. Practically, this means that more attention should be paid to the identification of the person’s aspirations and aims, while working together to identify how these objectives might be realised. Developing an approach that is able to incorporate both the person’s vulnerabilities and their attributes might more properly be referred to as ‘holistic’.

Stages of change

In most of the exiting projects that are considered to be examples of ‘good practice’, a recurring feature is the provision of a staged approach to exiting. Although these projects tend to operate with slightly different stages, they all tend to incorporate a developmental approach that is used to gauge the points of transition from involvement in prostitution to exiting or stopping (Prochaska et al. 1992; Ebaugh 1988; Levesque et al. 1999). The advantage of developing a staged model of exiting, it is suggested, is that it allows the monitoring of the development or progression of ser...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• List of Figures
• Preface
• Acknowledgements
• 1. The Dynamics of Exiting and Desistance
• 2. Examining the Process of Change
• 3. Barriers and Opportunities
• 4. Exiting Among Women Involved in On-Street and Off-Street Prostitution
• 5. Models of Service Provision
• 6. Exiting, Policy and Practice
• References
• Index