What’s Wrong with the CDC’s Public Health Model for Rape Prevention

Also on the Gender & Society blog  (copyright 2016 Jill Cermele and Martha McCaughey)

The 2014 White House Task Force on Sexual Assault on College Campuses has mandated that in order to continue to receive federal funding, colleges and universities must step up their game, including providing rape prevention education. The 2014 “Not Alone” report outlines the Center for Disease Control and Prevention’s (CDC) public health model of sexual assault prevention, and reiterates the need for evidenced-based programming to combat rape and sexual assault. The CDC’s public health model defines the terms and levels of prevention, and articulates what “counts” as primary prevention – namely, bystander intervention training and psychoeducation to shift rape-supportive attitudes. As we describe in detail elsewhere (see McCaughey & Cermele, 2015), despite the overwhelming evidence that self-defense (training and enacting it) works both to stop rape and to shift rape-supportive attitudes, the CDC does not discuss or recommend self-defense training in its public health model.

On the surface, the omission of self-defense training from the category of primary prevention is perplexing, considering the CDC’s own definition. Primary prevention is defined as thwarting violence before it happens, while secondary prevention includes strategies and responses that immediately follow victimization, such as counseling or medical care, to address the short-term effects. The CDC has consistently and openly argued that while teaching (often male) bystanders to intervene in and thwart sexual assault is an established primary prevention tactic, teaching women to intervene in and thwart sexual assault targeted against themselves is not.

This stance is flawed for two main reasons. First, both self-defense training and bystander intervention training target sexual violence at the same point in time – when a sexual assault is imminent or in progress. So while both meet the criteria for primary prevention, they differ on one important dimension: who is encouraged to intervene. Bystander training requires the presence of a (presumably) benevolent and engaged third party to thwart rape, contributing to the erroneous belief that the woman targeted for sexual violence cannot, or should not, intervene on her own behalf.

Self-defense training, on the other hand, disrupts the script of sexual violence by offering women a range of verbal and physical strategies to thwart rape, which, although it can include soliciting bystander intervention, does not require the presence of a bystander in order to prevent assault. Given that both methods of rape prevention education target sexual violence at the same point in time, with the same goal and even potentially similar methods, it stands to reason that they must be in the same category – they are either both primary prevention, or neither are.

Second, only one of these meets the CDC’s second criteria, that rape prevention education be demonstrably effective – and that is self-defense training. The data are clear—and reviewed in our article (McCaughey & Cermele, 2015)—that self-defense is effective in thwarting sexual assault. In addition, numerous empirical studies have documented that self-defense training is what the CDC calls a protective factor, and that women who have taken self-defense training are at less risk for sexual assault than those who have not, reducing risk of sexual assault by as much as 40%. Furthermore, self-defense training creates positive behavior and attitude change, including feelings of empowerment in women. Finally, women’s participation in self-defense training and the enactment of effective resistance strategies directly challenge the attitudes that permeate rape culture: that the safety and integrity of women’s bodies exists at the whim of men’s bodies. Women who learn to defend themselves learn to take themselves and their safety seriously in realistic ways, rather than simply following an unsubstantiated list of “don’ts” – don’t wear this, don’t go there, don’t be alone. Instead, they assess situations better than they did before their training, are more likely to identify situations that could be dangerous, and have the skills to respond if necessary.

We also reviewed the data on bystander intervention training (see McCaughey & Cermele, 2015), which are much less promising. There is some research demonstrating that participants in bystander intervention rape prevention education reported positive changes in attitudes and increased intent to intervene or increased self-reports of intervention. However, there is as yet no empirical data to suggest that bystander intervention programs are effective in actually thwarting rape and sexual assault. And yet, the CDC maintains its stance that bystander intervention training meets the criteria for primary prevention, and self-defense training does not.

This cannot continue. By the CDC’s own criteria, training women in self-defense is a demonstrably effective primary-prevention strategy in preventing rape and sexual assault, and is entirely consistent with the goals of a public health model in combatting the crisis of sexual assault on college campuses. At a time when so many organizations and task forces are looking to the CDC’s public health model for combating sexual assault, the CDC must begin to pay attention to the data and acknowledge women’s capacity for and right to resist sexual assault. Self-defense training belongs at the forefront of their recommendations for sexual assault prevention on college campuses.


McCaughey, M., & Cermele, J. (2015). Changing the hidden curriculum of campus rape prevention and education: Women’s self-defense as a key protective factor for a public health model of prevention. Trauma, Violence, and Abuse, online pre-print, 1-16. DOI: 10.1177/1524838015611674 tva.sagepub.com

10 responses

  1. Clearly the information presented here is factual and not opinion or point of view. Sadly these facts are not widely accepted by most of the people and institutions that are in a position to affect real change, or at least they are not willing to act upon them. So I strongly agree with the direction of the article but there is a serious question that arises from the persistent use of the phrase “Self Defense Training”. What does that term really mean? How is it defined and then further qualified in terms of what is being taught? Does a 2 hour class at the YMCA or local police station have the same effectiveness as a 30 to 40 hour scenario based structured training program? If the answer is yes then it would be easy to argue that the benefit is predominately physiological and that physical training is the minor influence here. From my own experience visiting self defense courses around the country and interviewing those that have attended such courses I believe this is perhaps just as or more harmful than having no training.

    Police and military tactics are rarely applicable and martial arts techniques depend heavily on style influence that create the making of a very heated conversation. Self Defense as referenced in this article is about a lot of things that have little to do with the police, military and martial arts tactics. It is easy to understand why administrators all the way up to the CDC might find recommending “Self Defense Training” as a primary goal for women very objectionable. Is it clear to everyone what “Self Defense Training” really entails including what is effective? Comprehensively resolving the definition of “Self Defense Training” might create a path forward that makes advocating for and implementing such programs easier for institutional administrators.

    1. Martha McCaughey | Reply

      Thanks for your comments. Yes, there are many versions of self-defense indeed. We recommend the excellent article by Martha Thompson published in the journal Violence Against Women in 2014 because Thompson outlines the elements of a distinctively feminist, empowerment-based self-defense course. We refer to this in the longer article upon which this blog post is based (in Trauma, Violence, & Abuse, 2015). It’s worth noting, though, that both training in and enacting self-defense (enacting whether or not one had previous training) have been found to be quite effective in thwarting assault. You mention that it’s easy to understand why administrators all the way up to the CDC might object to recommending self-defense training. Could you elaborate on this?

      1. My own experience and research originally did not lead me to any clear deductions as to what constitutes responsible self defense training. In addition self defense training is associated with martial arts and martial arts practitioners and the industry in general lacks the credential, respect and structure needed to provide proper vetting by an institution. I understand the concept of enacting some level of personal defense regardless of training and yes the research supports the positive outcomes associated with fighting back irrespective of the level of training. But by that logic simply giving someone permission to fight back is all that is needed, and that is very misleading and potentially dangerous. From what I have seen most training would be ineffective and all of it would be considered incomplete in my opinion. As a policy or decision maker at a university I would not advocate for self defense training based on the current maturity of the industry, there is just too much risk. Public institutions are very good at offering a lot of information without committing to something tangible and useful, often to avoid being held responsible. The CDC is simply willing to punt on the subject as there is no clear solution. I also think that the weak programs out there have created almost a stigma against such training. And by weak programs I am referring to programs most people see as the most reputable. Most men that visit my school do not believe any of it would be effective because they are thinking about a battle and winning, they can’t help it. For them it is a contest without consideration for a lot of effective strategies like “Passive Resistance”. In terms of rape avoidance winning might be as simple as making a decision not to go to the second floor at fraternity party. How many decision makers in regard to these policies are men or women that have no understanding of these concepts? And lastly the economic impact is huge. A properly developed and run 30 to 40 hour program is really expensive, who is going to pay for quality training. Who will administer the programs and on and on. The details of the above discussion is what led me to spend considerable time and effort in developing a more comprehensive program based on a formal curriculum that is built around the multiple and diverse phases of an attack.

        I applaud your efforts to educate and change the minds of people at the CDC and elsewhere that could help to create positive changes for women. I do think change initiated from outside the government and institutions would be more effective and beneficial. Or at least some partnering between private industry and educators.

  2. […] isn’t primary prevention.”  Um.  Yes, it is, as we have explained countless times.  Primary prevention, according to the CDC, stops an assault before it happens, […]

  3. […] As rape prevention educators, you emphasize “primary prevention,” but do not include self-defense or resistance as such.  Self-defense, you say, is “secondary prevention”–along with providing counseling and medical care to victims of completed rape.   As we have already argued, this is not a data-driven approach because the data show that self-defense is an effective sexual assault prevention strategy, and it is ultimately fueling a disempowered status for women on campus. […]

  4. […] in hopes that we could make the kind of splash on social media that you have.  We’ve blogged serious stuff. We’ve blogged silly stuff.  We’ve submitted a video in response to the one that the […]

  5. […] assault prevention office and the women’s center aren’t going to do it.  And the CDC still doesn’t want to embrace the data on the effectiveness of self-defense.  We also know RAD self-defense classes play a special role […]

  6. […] reduction” and “prevention” is a false dichotomy.  Indeed, self-defense fits all the criteria of “primary prevention” in the public health […]

  7. […] women’s practice of verbal and physical self-defense is.  (We have written about this here, here, here, and […]

  8. […] women’s practice of verbal and physical self-defense is.  (We have written about this here, here, here, […]

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