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Introduction and Overview¹

WORKSHOP OBJECTIVES

Countering violent extremism (CVE)² consists of various prevention and intervention approaches to increase the resilience of communities and individuals to radicalization toward violent extremism, to provide nonviolent avenues for expressing grievances, and to educate communities about the threat of recruitment and radicalization to violence. To explore the application of health approaches in community-level strategies to countering violent extremism and radicalization, the National Academies of Sciences, Engineering, and Medicine held a 2-day public workshop called Health Approaches in Community-Level Strategies to Countering Violent Extremism and Radicalization. The workshop, held in Washington, DC, on September 7 and 8, 2016, convened speakers with expertise spanning the domains of health care, mental and behavioral health, public health, homeland security, law enforcement, education, civil rights, and countering violent extremism.

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¹ The planning committee’s role was limited to planning the workshop, and this Proceedings of a Workshop was prepared by the rapporteurs as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. They should not be construed as reflecting any group consensus.

² Many participants noted that a common language and set of definitions is a challenge faced by the field of CVE, but for the sake of clarity, these proceedings will use the terms countering violent extremism, violent extremism, and extremist violence.

Topics explored included

• the evolving threat of violent extremism and radicalization within communities across America;
• traditional approaches to countering domestic violent extremism and radicalization;
• applying health-centered approaches (e.g., public health, health care, mental and behavioral health) to countering violent extremism and radicalization; and
• opportunities for cross-sector and interdisciplinary collaboration and learning among domestic and international stakeholders and organizations (e.g., community and/or faith-based groups, law enforcement, justice system, public health, health care, mental and behavioral health) for countering violent extremism and radicalization.

COUNTERING VIOLENT EXTREMISM

George Selim, director of the Office for Community Partnerships, U.S. Department of Homeland Security (DHS), and CVE Task Force, described the emergence of CVE. He stated that in the period immediately after the events of 9/11, the primary focus was on law enforcement and military-

led counterterrorism interventions. In 2006 and 2007, tactics expanded to include prevention strategies directed toward identifying and curtailing the process of radicalization that many foreign and domestic organizations use to attract and deploy individuals to commit terrorist acts, Selim explained. By 2010 and 2011, the U.S. government began to codify policy on CVE. Peter Romaniuk, associate professor in the department of political science at John Jay College of Criminal Justice, The City University of New York, proffered that the shift from counterterrorism to CVE reflected evolving, empirical developments in our understanding of violent extremism and radicalization.

People who radicalize may espouse extreme beliefs or opinions and attempt to significantly change the essential qualities of their society and government (Australian Government, 2016). The process is relatively uncommon, affecting only a small percentage of people in any given community. Likewise, a small number of people who become radicalized may go on to commit acts of violence to achieve their goals; this behavior is also referred to as violent extremism. Romaniuk interpreted the term violent extremism as being a relatively new addition to the lexicon, reflecting a shift in focus away from the deeply politicized term terrorism, and toward the processes at play in radicalization to violent extremism. Georges Benjamin, executive director of the American Public Health Association, talked about violent extremism, which has been defined as “the beliefs and actions of people who support or use violence to achieve ideological, religious, or political goals” (Australian Government, 2016). Michael Jensen, senior researcher, National Consortium for the Study of Terrorism and Responses to Terrorism (START), University of Maryland, defined violent extremism as “beliefs that justify the use of violence for obtaining a political or social goal.” Just as there are varying definitions of violent extremism, there is not yet consensus on how to define CVE. However Romaniuk commended the following definition for its focus on prevention by dissuasion rather than coercion:

Broadly, CVE is aimed at recognizing individuals who have become radicalized—or those who are vulnerable to radicalization—and intervening to prevent them from perpetrating acts of violent extremism. CVE differs functionally from counterterrorism in its focus on cross-disciplinary, community-based, resiliency-building efforts that interrupt the process of

radicalization toward acts of violent extremism. Romaniuk remarked that CVE has few, if any, direct precedents to inform the field.³

In the United States, violence linked to Islamic extremist beliefs tends to receive the most public attention and be perceived as the strongest threat. However, violent extremism is not limited to Islamic extremism; far-right, far-left, and single issue ideologies are also prevalent among those individuals who commit such violence. Irfan Saeed, director of the Office of Countering Violent Extremism, Bureau of Counterterrorism and Countering Violent Extremism, U.S. Department of State, explained that the government of the United States was founded on radical and extremist thoughts, and individuals with these beliefs are absolutely protected by the U.S. Constitution. Only when the line is crossed into violence can the government justifiably intervene. Several participants strongly cautioned against conflating extremism (or extremist beliefs) with violent extremism. For example, as Jalon Arthur, director of Innovation and Development, Cure Violence, School of Public Health, University of Illinois at Chicago, commented: “You can have ideas that are viewed as extreme and you can have ideas that are associated with radicals without violence even being a part of the equation. The fact that most extremists do not act on it is evidence of that.”

A major component of the CVE enterprise is identifying and intervening with individuals who are radicalized and likely to commit violence to achieve their views but who have not yet committed any crime. Thus, a key challenge is the public perception that certain communities are being “profiled” and subject to discrimination and victimization through CVE programming. Michael German, Brennan Center for Justice, New York University Law School, criticized CVE programming that is predicated on the false, invalidated assumption that bad ideas necessarily or exclusively lead to violence. He emphasized that it is very difficult to predict who will engage in violence, and that people with bad ideas are not the only ones who commit violence. Thus, he argued that there is a flawed, unscientific premise incorporated into the indicators of potential violence or potential radicalization, which are often characterized in terms of race, national origin, and ideology. In that vein, Laura Runnels, facilitator and engagement strategist at LARC, LLC, noted that there is tension to be resolved between CVE efforts aimed at protecting and preserving the society at large, and the fear that certain groups will continue to be marginalized and oppressed by the government. Addressing these challenges, she said, will require multidisciplinary, cross-sectoral approaches that strive to include, engage with, and empower communities. Furthermore, CVE programs that are implemented

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³ With the exception of certain types of analogous violence prevention efforts and approaches within the domain of public health, particularly those that target gangs.

must include evidence-based approaches that are centered on empirically established protective and risk factors.

PUBLIC HEALTH AND CVE

Borrowing a concept from the public health arena, Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado, framed CVE as a complex adaptive challenge; given the number of factors at play, one approach or intervention will not solve the problem. Instead, interventions may have an incremental positive effect coupled with some negative externalities. George Selim commented on the potentially negative connotations attached to prevention or intervention, pointing out that the overall spirit of CVE policy is not just to prevent or intervene with coercive measures. Instead, the U.S. government’s national strategy seeks to empower local partners and to invest in communities across the country to help them build and cultivate their own strategies shaped by local perspectives to enhance individual and community resilience.

Kiersten Stewart, director of public policy and advocacy at Futures Without Violence, called for embedding the prevention of violent extremism within a broader public health approach to violence. She argued that repositioning CVE within a public health framework provides the tools to do the requisite type of prevention-focused analyses, the first step of which is to clearly define the problem and the goals of the planned policies or actions. Examining push-and-pull factors from a public health perspective involves looking at individuals, societal and community influences, as well as the entire social ecology. She encouraged turning away from a focus on the rationale for violence and concentrating on preventing the acts of violence, suggesting that public health approaches can also add value to the CVE space by providing tools and mechanisms for understanding violence and what motivates it. She argued that placing violent extremism in the context of violence prevention—not in political or religious ideology—will strengthen efforts to prevent violence and better maintain CVE programmatic integrity.

While many panelists and participants argued that using public health in CVE was potentially dangerous, and raised many civil liberties, ethical, and legal concerns for health professionals and researchers, other participants and panelists in the workshop explored how models, strategies, and lessons learned from public health could strengthen and support the CVE enterprise.

David Phillippi, program coordinator for Parents for Peace, differentiated between legal responsibility and ethical responsibility. He asked how those issues apply to organizations outside the medical profession that do not necessarily have the same professional or legal responsibilities but that

adhere to similar ethical responsibilities in trying to interact with families and friends who are concerned about loved ones. Furthermore, he asked whether those legal and ethical responsibilities differ when working with a third party (friend or family member) rather than working with the individual directly. He advised that any CVE approach or framework should consider how it will affect the small independent organizations that will implement programs. He suggested developing a roadmap for creating viable civically and ethically legally responsible CVE programs for nongovernmental organizations (NGOs). Phillippi also highlighted the need for clear guidelines about ethical issues so when such situations do arise, a framework exists and is ready to use.

TOPICS HIGHLIGHTED DURING PRESENTATIONS AND DISCUSSIONS⁴

Throughout the 2-day workshop, many themes were highlighted by speakers and participants:

• An individual’s progression to extremism is complex, and there is no evidence to predict when or how an individual will act on violent impulses. Michael Jensen said that researchers are trying to identify a shared set of characteristics or a specific pathway that individuals take to become violent extremists, but ultimately researchers should conclude that such shared characteristics do not exist. Some researchers, said Mark Stainbrook, found shared motivations behind violent behavior, but, as Mike German points out, there is no evidence to predict when or how an individual will act on violent impulses.
• Gaps in research about CVE programs are negatively affecting best practices. Many presenters, like Peter Romaniuk, said it was difficult to determine whether programs were effective because they did not always participate in an evaluation or assessment of their efforts. To support the continued development and refinement of evidence-based policy may require continued assessment of methods and programs.
• Fitting practical solutions to CVE is often difficult with current political realities. Rebecca Skellett noted that it is difficult to tread

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⁴ This list is the rapporteurs’ highlights of main topics and recurring themes from the presentations, discussions, and summary remarks by the meeting facilitator, speakers, and participants. Items on this list should not be construed as reflecting any consensus of the workshop participants or any endorsement by the National Academies of Sciences, Engineering, and Medicine or the Forum.

• the line between achieving good outcomes and addressing political caveats imposed on work in the CVE arena. In fact, many programs have found preventing violent extremism works much more effectively when steps are taken to strengthen and improve communities instead of targeting CVE in a group or in an individual, as Alejandro Beutel and Mehreen Farooq described in their presentations.

• The unintended consequences of earlier CVE practices have hindered efforts to address violent extremism. Many presenters, like John Hick and Peter Romaniuk, lamented past attempts to curb violent extremism because they often resulted in groups and individuals feeling isolated and associating CVE with bigotry and profiling.
• Approaching violent extremism as a public health issue offers intriguing opportunities. Many speakers, like Michael Downing and Jihad Turk, believed that the best way to prevent individuals from radicalizing to violence was to build strong, healthy, welcoming, and resilient communities that are hostile to violent extremist ideologies. Georges Benjamin, David Eisenman, and Leesa Lin discussed public health models of prevention that could be effective at doing this.
• Health professionals face a set of practical and ethical challenges when working in CVE roles. John Hick, Leesa Lin, and Matthew Wynia also discussed some identified issues that have historically complicated the health professional’s role, such as patient threat assessments and being obligated to report to law enforcement. Screening programs and other population-level strategies were also debated.

PROCEEDINGS STRUCTURE

This proceedings will account for the presentations and discussions had at the September workshop in Washington, DC. It is organized to first present an introduction to our current understanding of the roots and sources of violent extremism in Chapter 2. It then discusses some of the contemporary approaches to curtail extreme violence in Chapter 3. Chapter 4 explores the challenges and unintended consequences of initial CVE actions as well as some of the opportunities our better understanding has afforded us. Chapter 5 applies health and public health models and approaches to CVE objectives. Finally, Chapter 6 suggests how CVE initiatives might move forward.

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