Sexual Abuse Treatment Research Articles

Child sexual abuse treatment: misinterpretation and mismanagement of child sexual behavior.

The purpose of the study was to examine caregiver understanding of the impact of child sexual abuse and the management of abused children in residential treatment. A purposive sample of 20 registered nurses and child care workers were interviewed about their experiences working in residential treatment and their knowledge about child development and child sexual abuse and its application to practice. Data from interviews and field notes were analysed using dimensional analysis. Caregivers had limited knowledge of the sequelae of child sexual abuse. Developmentally appropriate behaviour of sexually abused children, as well as behavioural manifestations of child sexual abuse, were often misinterpreted and mismanaged. Residential care of sexually abused children should be based on sound developmental principles and caregiver sensitivity.

Prevention of Child Sexual Abuse

In response to an increase in public awareness and interest in the problem of child sexual abuse, programs have been developed to promote the awareness, prevention, and treatment of sexual abuse. These programs have been varied in scope, focus, and effectiveness. This article reviews the child sexual abuse literature, with particular emphasis on efforts aimed at the prevention of child sexual abuse. Prevention efforts targeting potential victims as well as parents, teachers, and offenders, are reviewed and evaluated. Overall, there is not enough adequate work being done to prevent child sexual abuse. More efforts need to address child sexual abuse prevention by targeting adults who can help children avoid such an experience and adults who may perpetrate against children. Suggestions about future preventive endeavors, based on this review, are offered.

Case Study of a Five Year-Old Israeli Girl in Movement Therapy

The authors describe the treatment of a five year-old Israeli girl by an Israeli movement therapist who was trained in the United States. The somatic transference and countertransference dynamics which inform the movement therapy process are discussed. Innovative concepts are employed to describe these dynamics in which sensations from the child's traumatic injury are transferred to the therapist's body. Two case discussions follow, written by two United States-trained dance/movement therapists experienced in child therapy. These case discussants highlight important dimensions of movement therapy with abused children specifically related to case conceptualization, movement assessment, treatment planning, collaboration, and some unique qualities of dance/movement therapy intervention in comparison to related forms of treatment. Questions emerge regarding possible cross-cultural differences in the context for dance/movement therapy, and for the treatment of sexual abuse.

Telling Questions More Details-Less Anxiety

Abstract A primary focus of providers of child sexual abuse treatment is preservation of the delicate balance between child treatment and legal action. It is important that children bring up true information without the taint of leading questions. Having a single structured question as a regular part of the weekly introductory segment of a group or individual treatment session, as well as the same topic more fully explored in themes and therapeutic activities throughout the session reduces contamination of child testimony. Responses often provide valuable insight not revealed in other intervention strategies and provide incremental preparation for the “telling of the story.” The ordering and creation of questions to increase ease of answering and decrease higher levels of anxiety is one of the innovative ways to use structured questions to encourage successful child client participation, aid client de-sensitization, address individual treatment goals, and thereby enhance progress in therapy.

Perceptions of interventions for child sexual abuse in an urban South African sample.

A questionnaire was used to study perceptions of interventions for child sexual abuse in a nonrepresentative urban South African population of 132 African/Black participants (61 men and 71 women) from the general public of Mankweng. Their ages ranged from 21 to 60 years (M age = 32.2 yr., SD = 10.4). Analysis indicated these participants clearly supported most of the components of nonadversarial approaches. Women were more positive about a nonadversarial approach than men; however, participants disagreed on questions about controlling the offender and whether an accused relative should move out of the home of the victim. Participants supported prosecuting offenders and longer prison sentences and did not favour leniency for first-time offenders. They further believed children, the family, and even less the offenders should receive treatment.

Child Sexual Abuse in Asian American Families: An Examination of Cultural Factors That Influence Prevalence, Identification, and Treatment

Child sexual abuse affects thousands of families each year. Issues pertaining to the prevalence, identification, and treatment of sexual abuse have been relatively well explored in the literature as they pertain to the dominant European American culture. These issues, however, are still relatively unexplored in terms of how sexual abuse affects Asian American families and the Asian American community. We review the relevant literature in Asian American families. These matters are explored in the context of Asian American values such as collectivity, conformity, inconspicuousness, middle position virtue, shame, self-control, and fatalism. Attitudes toward family, sexuality, and the mental health system are also discussed. Cultural and institutional barriers to underutilizing mental health services are also explored, and suggestions for overcoming these barriers are offered.

Views of Child Sexual Abuse in Two Cultural Communities: An Exploratory Study among African Americans and Latinos

This exploratory study investigates knowledge and ideas about child sexual abuse among African Americans and Latinos through focus group discussions. Participants defined and described child sexual abuse, acknowledged that it occurred in their communities, and expressed their sense that family risk factors, risky institutions, and offender propensities were its root causes. Latino participants identified cultural transitions as another contributor. Responses and conversational style differed somewhat by gender and cultural identity. The authors discuss implications for child sexual abuse prevention, intervention, and research.

Sexual Reconviction for Sexual Offenders Discharged from Prison in England and Wales: Implications for Evaluating Treatment

The sexual reconviction rate for sexual offenders discharged from prison has declined and both two and four year post-release rates are low. Levels of sexual offending are not falling per se as the number of reported sexual offences has risen yearly, but against this rise, the number of convictions/cautions for sexual offences is falling. The probability of a reported sexual offence leading to a conviction has been halved and this is cause for concern. The theoretical implications of the low base rate of sexual reconviction for sexual offenders discharged from prison are discussed in relation to the evaluation of treatment programmes for sexual offenders in custody. New outcome measures are proposed to supplement sexual reconviction data and the reliability of these measures are discussed. (Abstract Adapted from Source: British Journal of Criminology, 2001. Copyright © 2001 by Oxford University Press) Recidivism Rates Offender Recidivism Sexual Assault Offender Foreign Countries England Wales Cohort Studies 1990s Adult Male Adult Offender Adult Violence Adult Parolee Adult Treatment Sexual Assault Treatment Offender Treatment Correctional Institution Treatment Inmate Treatment Adult Inmate Male Inmate Male Offender Male Treatment Male Violence Treatment Effectiveness Treatment Outcome Incarcerated 12-01

SEX OFFENDER TREATMENT: THERAPISTS' EXPERIENCES AND PERCEPTIONS

The literature portrays work with sex offenders as mentally, physically, and emotionally draining. However, the therapists working in the outpatient Sexual Abuse Treatment (SAT) program at a regional mental health center, while not denying the challenges of this work, describe their experiences as generally positive and rewarding. Because these therapists' experiences seemed to contrast with the literature, a qualitative descriptive study was conducted to examine the SAT therapists' experiences and perceptions. Seventeen SAT therapists were individually interviewed. Interviews were audio taped, transcribed verbatim, and analyzed using constant comparative analysis. The therapists in this study indicated that although sexual offender treatment is a stressful area to work in, it offers many rewards and is viewed as "a challenge and privilege." Exploring the positive as well as the negative impacts of working with sex offenders may help identify additional coping strategies or mediating factors for this challenging work.

Child sexual abuse in Asian American families: An examination of cultural factors that influence prevalence, identification, and treatment.

Child sexual abuse affects thousands of families each year. Issues pertaining to the prevalence, identification, and treatment of sexual abuse have been relatively well explored in the literature as they pertain to the dominant European American culture. These issues, however, are still relatively unexplored in terms of how sexual abuse affects Asian American families and the Asian American community. We review the relevant literature in Asian American families. These matters are explored in the context of Asian American values such as collectivity, conformity, inconspicuousness, middle position virtue, shame, self-control, and fatalism. Attitudes toward family, sexuality, and the mental health system are also discussed. Cultural and institutional barriers to underutilizing mental health services are also explored, and suggestions for overcoming these barriers are offered.

Review of Child abuse: New directions in prevention and treatment across the lifespan.

DAVID A. WOLFE, ROBERT J. MCMAHON, and RAY DeV. PETERS (Eds.) Child Abuse: New Directions in Prevention and Treatment Across the Lifespan Thousand Oaks, CA: Sage Publications, 1997, xiv + 293 pages (ISBN 0-7619-1096-4, us$34.95, Softcover) Reviewed by HEATHER SEARS This edited book offers a diverse collection of chapters that describe innovative approaches to the treatment and prevention of child physical and sexual abuse. Readers can peruse contributions from leaders in the field that depict recent efforts to address the complexity of these problems. Researchers, clinicians, or students who expect summaries of what is known about the four forms of child maltreatment (i.e., physical abuse, sexual abuse, psychological abuse, and neglect) and how these experiences are manifested across the lifespan may feel misled by the broad title. Psychological abuse and neglect are not covered. But the editors' selected focus on physical and sexual abuse is consistent with the research and clinical attention that has been given to these topics. This focus also has allowed the editors to assemble chapters that, taken together, discuss a wide range of treatment and prevention issues related to physical and sexual abuse that often are reduced to a paragraph or two in summary articles, if they are mentioned at all. For example, individual chapters examine the expressions of particular forms of abuse (e.g., dating violence) and consider unique populations that deserve closer empirical and clinical attention (e.g., children who witness violence between parents, sexually abused boys). The first section addresses treatment and prevention of child physical abuse. A strength of this section is the two chapters that focus on abusive parents. In one, Joel Milner and Cynthia Dopke review research that has examined the biological, cognitive/affective, and behavioural characteristics of abusive parents; in the other, Sandra Azar presents a cognitive behavioural framework for understanding and working with parents who have physically abused their children. Academics and students who are concerned with the impact of abuse on children will find these chapters informative regarding issues pertinent to parents (i.e., mothers). Practitioners who work with abused children will also benefit from a reminder of the various individual and situational challenges many of these parents face. Prevention of physical violence is addressed in three chapters. One by David Olds describes a prenatal and early childhood home visitation program that has been implemented to enhance maternal and child functioning in low-income families in New York, Tennessee, and Colorado. Two chapters, one by Marlies Sudermann and Peter Jaffe and one by David Wolfe and his colleagues, describe programs that have been implemented in Ontario to prevent violence in teenagers' relationships, especially their dating relationships. These three chapters highlight the importance of tackling the topic of physical violence with children and their caregivers at various points during the children's development, and offer models of how such interventions might take place in schools and communities The second section consists of five chapters that focus primarily on treatment issues in instances of child sexual abuse. In their chapters, Lucy Berliner and John Briere present models of interventions with children and adults, respectively, who have been sexually abused as children, and will be of interest to practitioners and students in clinical training. Both authors review the relevant treatment outcome literature, situate their models in an appropriate theoretical framework (e.g., attachment theory), and attend to developmental issues that may be helpful for facilitating clinical work. The strength of each of these chapters lies in its final section which describes how the proposed model is implemented in treatment. A chapter by William Friedrich addresses issues of treatment with boys who have been sexually abused. …

So Few Convictions

This study examines the role of client-related characteristics in the legal processing of sexual assaults. Data were collected from the hospital and legal records of 187 women who presented to a sexual assault treatment center and the police of a large Canadian city in 1994. The data analyses revealed that cases involving older women and women who did not physically resist the assailant were less likely to have resulted in a charge. However, women who were known to the assailant for more than 24 hours (including current or previous partners) were more likely to see their cases forwarded for prosecution.

Intensive family preservation services: an examination of critical service components

A treatment programme for child victims of sexual abuse within the family has been evaluated in terms of psychological and behavioural outcomes for the young people two years after beginning therapy. The Canadian programme was based on principles established by Giarretto in his Child Sexual Abuse Treatment Program (CSATP). Screening by child protection workers selected potential candidates. However, because of limited resources, referral of less than half of the originally screened families was made, even though they were judged suitable for participation. This made available an untreated comparison group (n = 30), similar in many ways to the treated families (n = 27). After two years the treated adolescents had largely recovered levels of self‐esteem obtained in normative samples, and depressive affect had diminished markedly, as had problem behaviours. By contrast, the untreated adolescents had retained low levels of self‐esteem, and high levels of depression. Negative behaviours (delinquency, running away from home, acts of deliberate self‐harm) had deteriorated after two years. This was linked both to further within‐family abuse (in a fifth), followed by a drift in some into street life. Despite its apparent success, the CSATP could not be continued because of lack of funding, and problems in maintaining a community development model for supporting a humanistic programme.

The Unique Benjamin Wolstein as Experienced and Read

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsSue A. ShapiroSue A. Shapiro, Ph.D., supervising analyst, New York University, Postdoctoral Program in Psychoanalysis; clinical supervisor, City University Doctoral Program in Clinical Psychology; founder, Center for the Study and Treatment of Sexual Abuse and Incest, Manhattan Institute for Psychoanalysis.

Child sexual abuse II: treatment.

To evaluate the scientific literature concerning the treatment of child sexual abuse. A critical review of the scientific literature. There are only nine published research studies in which subjects were randomly assigned to an index treatment or treatments and a comparison treatment or no-treatment control group. In seven of the studies, the index treatment exceeded the control or comparison group in regard to treatment outcome; in two studies it did not. The successful treatments involved group therapy, combined individual and group play therapy and cognitive behaviour therapy. Treatment should be based on an explicit conceptual model of the psychopathology of sexual abuse. The University of Queensland Sexual Abuse Treatment Project, which is based on a transactional model, is described.

Counselors' Beliefs About Ritual Abuse: An Australian Study

ABSTRACT This study compares the beliefs held by Center Against Sexual Assault (CASA) workers, psychiatrists, and psychologists about ritual abuse. These beliefs were examined across a number of dimensions, of which five are discussed here: definitions of ritual abuse; number of cases identified between 1985–95; belief of client statements; religious beliefs; and training in therapy for sexual assault. In spite of the literature indicating broad disagreement with the definition of ritual abuse in other studies, results indicate 70% of all counselors agreed with a single definition of ritual abuse, and 85% agreed that ritual abuse was an indication of genuine trauma. There were 153 cases of ritual abuse identified by counselors between 1985-1995. Not one of these counselors believed that any of the claims made by their clients were intentionally fabricated. Overall, the CASA workers were much more likely to believe their client's ritual abuse and marginally more likely to identify ritual abuse cases than other therapists. Religious beliefs had no relationship to the identification of ritual abuse. Training in recognition and treatment of sexual abuse was significantly positively related to the identification of ritual abuse cases.

Visual Voice and Expression

This paper demonstrates the benefits of Spontaneous Art Therapy as a primary intervention method within the group setting for sexually abused, latency-age girls (9-12 yrs.). Working in art gives these children a visual voice: an ability to express their feelings about their abuse and communicate both present needs and hopes for the future. This material is based on group work which took place at the Peel Collaborative Child and Adolescent Sexual Abuse Treatment Program (PCCASATP) in Mississauga, Ontario. Survivors come to this free program that offers individual trauma assessment and group treatment opportunities for children and adolescents ranging in age from 3 to 17 years.

Advantages of Heterogeneous Therapy Groups in the Psychotherapy of the Traumatically Abused: Treating the Problem as Well as the Person

The authors combine a social-constructionist perspective with a psychodynamic one in discussing the problem of trauma and its treatment. They argue that effective treatment of traumatic physical, sexual, and psychological abuse must do more than alleviate the pain of the sufferer. Factors that cause and perpetuate abuse must be addressed by the abused person in conjunction with other nontraumatized persons who may have been abusive or passive in the face of abuse. An argument is made for heterogeneous therapy groups as a context for this to occur.

Treatment of Sexual Abusers in Belgium

Violence against women and children, be it intrafamilial or extrafamilial, is obviously a matter of major concern in Belgium. In the early 1980s, the focus of interest shifted from the victims of violence in general to the more emotionally charged sexual violence in particular. This evolution led to new penal laws on rape, pornography, and pedophilia. In the 1990s, sexual offender treatment has become acknowledged by the government as a policy priority. Several initiatives have been endorsed in order to implement the treatment of sexual abusers in prison, in psychiatric units, and in the community. In this article, some controversial issues are discussed more in depth: (a) the necessary deal therapists must make with the referring penal law authorities, (b) the role of coercion in treatment, and (c) the liability of therapists with high-risk clients.

Respite from stress and other service needs of homeless families.

This paper is a description of qualitative interviews with homeless mothers participating in an outdoor camp program designed as time out from the stressful conditions of shelter living. In addition to evaluation of family satisfaction with camp, the individual interviews and parental discussion groups offered at camp enabled the women to share stories about some of the obstacles they encounter in moving toward self-sufficiency and in parenting their children. Gaps in services to help overcome these obstacles ranged from learning to read to treatment of childhood sexual abuse and more comprehensive substance abuse treatment. Suggestions for expansion of the program to better meet needs of families included support groups and referrals to community mental health services.