Ritual,and child sexual abuse,but not ritual child sexual abuse

Central to the controversy over ritual (satanic) child sexual abuse have been claims concerning agency ‘diagnoses’ of cases. Specifically, it has been alleged that agency findings of ritual abuse have been erroneous and are the product of poor practice. There is, though, little systematic information regarding agency assessment of suspected ritual abuse cases. This paper presents two cases where there was evidence both of child sexual abuse and ‘ritual’ but where agencies adjudged that these aspects occurred independently of one another and were not indicative of ritual child sexual abuse. The existence of these cases underlines the need for a broader and more balanced debate in respect of ritual abuse in general and the agency handling of these cases in particular. Copyright © 2000 John Wiley & Sons, Ltd.     

Assessment and intervention in cases of suspected ritual child sexual abuse

Agency workers have been heavily criticized over their handling of alleged ritual child sexual abuse cases, particularly in respect of their assessments and interventions. However, a study of referrals to police and social service departments revealed that agency workers raised suspicions of ritual abuse in respect of both child ‘victims’ and adult ‘survivors’ very rarely. Furthermore, they did this only after an assessment which showed the cases to possess a number of ‘troubling’ features. While agency workers believed that all the child ‘victims’ had been subject to serious sexual abuse, virtually all of them were circumspect as to whether this had occurred in a ‘ritual’ context. Initially, agency workers were generally open-minded as to the experiences of adult ‘survivors’, but by the end of their assessments, they tended to be more concerned about their mental health and less concerned about issues of ritual abuse. Finally, agency workers appeared to act appropriately in terms of the types of intervention they used and the way in which they applied these. These results suggest that there should be more confidence in the ability of agency workers to respond to cases of alleged ritual abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

Abusing victims: detention of child sexual abuse victims in secure accommodation

Sexually abused children and adolescents, in limbo between revelation of abuse and trial of an alleged offender, or in emotional turmoil after such abuse, need special care and support. Evidence indicates that a number of such children are held in local authority secure centres, on various grounds: to protect them from further sexual assaults by an adult offender; because of their persistent absconding from non-secure residential centres; and because of their disturbed behaviour (including suicidal behaviours), which may have been caused by the assault. Victims of sexual abuse are held with juveniles on remand for serious crimes (including rape and murder), or (because they are too young for youth detention centres) with young adolescents who are held in detention following conviction for such crimes. Evidence is produced from case histories, and from a survey of 15 of the 27 secure detention centres for children and young people in England, that the mix of abused, disturbed and very aggressive children is highly problematic. In worst case scenarios, victims of child sexual abuse are sexually assaulted by juvenile rapists with whom they are housed. © 1998 John Wiley & Sons, Ltd.     

The ritual abuse of children: Implications for clinical practice and research

The development of a 14‐year‐old female from defending herself from sexual crimes to committing such a crime is presented in case‐report form. Her individual history, family dynamics, and transgenerational patterns are explored. A review of the current literature is utilized to understand why some abused persons become abusers.     

The Norwegian police and victims of elder abuse in close and familial relationships

Over recent decades, domestic violence or family violence, violence against women and child abuse has received much attention in the media, in political discourse and in social research. However, abuse of older adults arouses limited interest. In government action against domestic violence and in police guidance manuals, the elderly receive little attention. The aim of this article is primarily to demonstrate how the police attempt to prevent elder abuse in close relationships, especially in parent-child relationships. This article highlights some contradictions between the need of the police to produce criminal cases (often contrary to the interests of the victims) on the one hand, and the police's duty to prevent further abuse on the other. Research has documented that help and prevention measures in question make the situation even worse for the victims they are meant to help.     

The feasibility of goal attainment scaling to measure case resolution in elder abuse and neglect adult protective services intervention

Objectives: This pilot study describes implementation procedures of goal attainment scaling (GAS) and examines the feasibility of using GAS to measure the multifarious intervention outcome of case resolution in elder mistreatment (EM) adult protective services (APS).

Methods: Substantiated EM victims (n = 27) were recruited prospectively from the State of Maine APS. An adapted GAS approach was implemented involving development of a pre-populated goal scale menu and web-based GAS application.

Results: The GAS menu comprised 18 goals and corresponding scales spanning several domains of case resolution: social support, service access, health/functioning, enhancing independence, and protective measures. The overall GAS process had mean length 33.8 min per case. The mean GAS summary t-score (54.3) aligned with theoretical expectations.

Discussion: Without a measure of case resolution, research cannot compare the effectiveness of different EM intervention models. Findings suggest that GAS is a feasible, client-centered strategy to measure the multifarious EM intervention case resolution outcome.     

Profiles of adult survivors of severe sexual,physical and emotional institutional abuse in Ireland

Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups that described severe sexual (N = 60), physical (N = 102), or emotional (N = 85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post‐traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profile of survivors of severe physical abuse occupied an intermediate position between the other two groups. A thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse, since this may have important implications for the intensity of services required. Survivors of severe sexual abuse may require more intensive services. Copyright © 2009 John Wiley & Sons, Ltd.     

A comparison of two programmes for victims of child sexual abuse: a treatment outcome study

This study aimed to evaluate the comparative effectiveness of individual therapy and combined individual and group therapy in the treatment of the psychological sequelae of child sexual abuse. The Child Behaviour Checklist (CBCL), the Youth Self Report form (YSR), the Children's Depression Inventory (CDI) and the Trauma Symptom Checklist for Children (TSCC) were administered before treatment and 6 months later to a group of 20 young people who participated in individual therapy (IT) programmes and to a group of 18 young people who participated in programmes that involved combined individual and group therapy (IGT). For both types of programmes, statistically significant improvement occurred on the following scales: the total problems, internalizing problems, externalizing problems, withdrawn, somatic complaints, anxious/depressed, social problems, attention problems and aggressive behaviour problems CBCL scales; the total depression, interpersonal problems and anhedonia CDI scales; and the depression and anger TSCC scales. The only scale for which one therapy programme led to greater improvement than another was the CDI ineffectiveness scale. The IGT programme led to a reduction in the mean CDI ineffectiveness score, whereas a slight increase in the mean ineffectiveness score occurred in the IT group. There were no significant differences in the rates of clinically significant improvement associated with the two treatments and no major differences between cases who improved and those that did not improve over the course of therapy. From this study, it may be concluded that after 6 months, individual therapy and combined individual and group therapy were equally effective in the treatment of the psychological sequelae of child sexual abuse. Copyright © 2002 John Wiley & Sons, Ltd.     

Beyond belief: Beyond help? Report on a helpline advertised after the transmission of a channel 4 film on ritual abuse

This paper summarizes the calls received on a national helpline promoted after the screening of a television programme on ritual abuse in the Dispatches series on Channel 4 in February 1992. The helpline was organized by the educational charity Broadcasting Support Services. The helpline dealt with 191 calls of which nearly half concerned ritual abuse. Thirty-nine per cent of all calls were from current victims or survivors of ritual abuse.     

Emotional abuse and emotional neglect subscales of the CTQ: Associations with each other, other measures of psychological maltreatment, and demographic variables

The goal of this study was to explore the conceptual distinctness between the constructs of emotional abuse and emotional neglect. This was achieved through a comparison of the emotional abuse and the emotional neglect subscales of the Childhood Trauma Questionnaire (CTQ). The two scales were compared with respect to each other, demographic variables, and other measures of psychological maltreatment. Two hundred and fifty three employees at a social service agency completed five scales of adult recall of childhood psychological maltreatment including the CTQ-EA subscale and the CTQ-EN subscale. Results revealed moderate associations between the two scales, strong associations with other measures of psychological maltreatment, and a mixed pattern of associations with demographic variables. Data suggest considerable but not complete overlap between these two subscales. Directions for future research are discussed.     

Disclosure among victims of elder abuse in healthcare settings: a missing piece in the overall effort toward detection

Elder abuse remains a largely hidden problem in our society and only a small minority of victims are connected to formal support/protective services. Healthcare settings have been identified as a critical milieu to uncover cases of elder abuse; however, under-detection in these settings is a major issue. Victimization disclosure is an important component within the overall detection effort, yet it has received little attention in the elder abuse literature. Drawing on relevant literature from other domains of family/interpersonal violence, this article highlights the disclosure process, as well as disclosure barriers, facilitators, and competencies to consider when working with older adults.     

Psychological abuse in Spanish same-sex couples: prevalence and relationship between victims and perpetrators

This study investigates the prevalence of psychological abuse victimization in same-sex couples and the relationship between being a victim and a perpetrator of these negative behaviours. The final sample consisted of 107 adults residing in Spain who identified themselves as lesbian women and gay men, and who had been involved in a conflictive same-sex relationship. Participants were asked how frequently they would label their experience of psychological abuse and three different estimation methods were used. Furthermore, the relationship between being a victim and being a perpetrator of psychological abuse behaviours was calculated through the behavioural estimation method using a questionnaire. The results showed that the prevalence rates varied from 11.3% to 56.6%, depending on the estimation method, and they revealed that there was no correlation between receiving and enacting psychological abuse behaviours. The variation in prevalence rates highlights methodological differences that limit the extent to which comparisons can be made across studies. Three estimation methods are introduced to stimulate future research on this issue.     

Interviewing victims of sexual abuse with an intellectual disability: a dutch single case study

The approaching to use with people with an intellectual disability who are (suspected) victims of sexual abuse is a challenge for social professionals. Being at the mercy of professional facilities, the victims are in a vulnerable position. They have limited capacities to defend themselves against the intimidations of perpetrators and to deal with the consequences of the terrifying happenings. Finally, sexual abuse is a criminal offence. Much depends on the quality of the interviews. In the Dutch practice of forensic reactions to (suspected) sexual abuse of people with an intellectual disability, experience has been acquired with different types of interviewing.

With the help of a single case study between a health professional and a victim, these forms of interviewing are demonstrated. The professional pursuit is to let the client disclose what has happened in their own words. The study shows that in social health and welfare practices the professional task is to navigate between, on the one hand, the communicative space for the client to provide free recall and, on the other hand, the need to provide help to clients with an intellectual disability to verbalize inner cognitions and emotions.     

Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study

Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.     

Challenges in assistance provision to child victims of transnational trafficking in South Africa

Child trafficking is a violation of multiple human rights and a child protection challenge in South Africa and worldwide. Thus, assistance provision can be a protective factor in the emotional and the psychosocial well-being of trafficked child victims. Stakeholders (including social workers) working in the field of trafficking were studied qualitatively to understand the nexus between child trafficking and service provision. The challenges the participants had encountered within assistance provision were explored through in-depth interviews and analysed using thematic analysis. The findings from the study indicate that assistance provision is not an easy linear process and that multinational, multi-agency, long-term sustained response, with multi-focus on prevention, prosecution and protection (including rehabilitation) is required to enhance successful resettlement and adaptation. This response should be based on the rights of the child rather than based on law enforcement and immigration.     

Transference and countertransference in the treatment of adult survivors of abuse with a somatoform disorder

The understanding of transference and countertransference has changed a great deal since Freud introduced the terms. A case example indicates one way the patient’s and clinician’s past experiences and expectations interact to create a here and now relationship that is highly influenced by transference/countertransference. The understanding of both terms as aspects of a mutually constituted interaction has practice implications for the treatment of adult survivors of abuse who have a somatoform disorder.     

A Telephone Counseling Program for Elder Abuse in Japan

ABSTRACT

In the 21st century, one-fourth of the Japanese population will be 65 years and older. Not only is the duty to report elder abuse not defined by the law but there is no special organization with clinical facilities to respond to incidents of elder abuse. A report in 1994 by the Society for the Study of Elder Abuse (SSEA) showed the need for definitive social measures to prevent elder abuse. Based on that research, SSEA organized the Japan Elder Abuse Prevention Center and initiated a volunteer telephone counseling service “Help Line” that was available for several hours on Mondays. Within an 18 month period, 209 cases were handled of which 150 concerned abuse, neglect, and financial exploitation. Callers were more often the elder or the daughter than other relatives or outsiders. Sons were the more prevalent perpetrators, and financial abuse the most common type of mistreatment reported. Recommendations include new laws and social welfare policies that adapt to the changes in an aging society.     

Childhood and adult sexual abuse: relationships with alcohol and other psychoactive drug use

Questions concerning sexual abuse before and after the age of 16 years were included in a general population survey of a representative sample of 1052 UK women and 975 UK men. A total of 12.5% of women reported experiencing some form of sexual abuse before the age of 16 years. The corresponding ?gures for men in this category were 11.7%. After the age of 16, the ?gure for women remained at this level. However, the proportion of men reporting these traumatic experiences dropped to 3.2%. Sexual abuse both pre and post age 16 was associated with being single or cohabiting, with higher levels of cigarette‐smoking, alcohol consumption, experience of alcohol‐related problems and use of illicit drugs. The relationship between drinking and other forms of psychoactive drug use and sexual abuse is complex. Some possible explanations for this connection and its therapeutic and practical implications are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions

Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver–operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.