Facilitating interviews with children who may have been sexually abused

The introduction of the Memorandum of Good Practice on interviewing children who have been sexually abused has had an important unifying effect on professional practice. However, because of the traumatic nature of sexual abuse there will be a group of children about whom there are high levels of suspicion and where arrangements need to be made for their future care, protection and treatment. These include children who have learning disabilities or communication problems, have psychiatric disorders associated with abuse, or where there have been considerable delays since allegations were first made. Such children require a second-stage facilitative assessment interview. These include different forms of questioning, and the use of a wide range of prompting materials including art work, free and structured play context and the use of anatomically correct dolls. These approaches are reviewed and illustrated through case studies.     

Anatomical dolls: their use in assessment of children who may have been sexually abused

This article examines anatomical dolls in interviews of children who may have been sexually abused from three perspectives. The article summarizes research findings on anatomical dolls, discusses advantages and disadvantages of using them, and describes endorsed doll uses. Although additional, ecologically-valid research is needed on anatomical dolls, the selective use of anatomical dolls, as communication aids, when interviewing children who may be reluctant or unable to describe sexual abuse is warranted.     

A relational understanding of the needs of siblings of children who have been sexually abused

This participatory research project highlighted the views and experiences of young people who are the brothers and sisters of children and young people who have experienced child sexual abuse. By working with young people who had experienced sexual abuse and their siblings, this practitioner research sought to give these young people a voice. The research involved a group process with young people who have experienced sexual abuse and have siblings, and one-to-one online consultations with the brothers and sisters of young people who have experienced abuse. All the young people spoke of their sibling and family relationships as unique and requiring unique responses to these relationships by services and health-care professionals. Siblings’ needs in the aftermath of a child sexual abuse discovery are often overlooked. This research describes how just as children who have experienced sexual abuse may feel anger, fear, guilt, shame, anxiety, and confusion, so do their siblings. Brothers and sisters of young people who have experienced sexual abuse describe significant relational trauma with intense emotional experiences of isolation, confusion, sadness, and anger. There is a real need to support young people and families to find words and develop capacities to talk about child sexual abuse -- a need to find supportive ways to speak about what has occurred and understand its impact on all. The study clearly demonstrated the significant level of need and impact on brothers and sisters of young people who have experienced sexual abuse.     

Partner abuse among women whose children have been sexually abused: an exploratory study

To explore partner abuse among women in families in which a child has disclosed child sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Language,discourse and empowerment: changing approaches to children and young people who have sexually abused others

The sexual abuse of children by other children and young people has gained an increasing profile during the previous decade. It has been increasingly recognised that there has been a significant change in the way that this issue has been responded to, both in philosophy and practice, as research has developed and also as the value base of initial constructions of this behaviour has been questioned. This article describes the development of a project to work with children and young people who have sexually abused from its inception in 1995 to the present, outlining the original assumptions and working practices and the reasoning behind changes. The growth of the project illustrates the changing nature of constructions of this behaviour, along with the introduction of new theoretical approaches to respond to this change. In particular, the changes can be seen to reflect a move away from a ‘modernist’ position and this is discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

Treatment issues with sexually abused young children

Sexual abuse of very young children confronts therapists with special difficulties in regard to the children, their parents, and possible legal consequences. This California treatment program involves parents and children in parallel groups, along with individual therapy. Factors with which therapists must deal are also presented.     

Psychoeducational groups with foster parents of sexually abused children

Psychoeducational groups for foster parents of sexually abused children were successfully delivered. Groups with nonrelative foster parents required less basic behavior management training than groups for foster parents related to the children in their care. Relative groups also required considerable attention to issues of visitation with birth parents. The groups helped foster parents improve their ability to care for sexually abused children. Participants were highly satisfied with the groups. Additional program development and research is clearly warranted.Ms. Winterfelt is in private practiceThe Project was supported by the Children's Bureau, ACF. DHHS.Copies of the training curriculum and videotape are available from Ms. Yeaton, Dept. of Psychiatry, Children's Hospital, 747 52nd Street.     

Parental support and outcome in sexually abused children

The purpose of this study was to compare how parental support, attachment of the parent, and the child's report regarding the quality of the parent/child relationship differentially relate to child and parent reports of the child's symptomatology. After controlling for those variables that covary with it, parental support was only significantly related to 2 of 17 scales of parent- and child-reported symptomatology. Parent attachment and the child's report regarding the quality of the parent/child relationship were better predictors than parental support of the child's outcome but varied in the manner in which they contributed to outcome.     

Aggressive behavior among women sexually abused as children

Although research shows that sexually abused children appear to be at risk of subsequent aggressive behavior, few investigations address whether such behavior persists beyond childhood. This research describes the self-reported adolescent and adult fighting behavior of 136 women sexually abused as children and examines the role of intervening variables in the risk of such behavior. The women are part of a longitudinal study of 206 primarily low-income, urban women whose abuse was documented at the time it occurred. Fighting was common, particularly during adolescence. Adult aggression was strongly associated with being a victim of violence by an intimate partner. A history of exposure to other forms of violence significantly increased the risk of fighting while strong maternal attachments mitigated the risk, primarily by reducing the likelihood of involvement in an abusive intimate relationship.     

Responding to teen dating violence: Perspectives from mothers who have been abused and seeking services in domestic violence shelters

ABSTRACT

Teen dating violence (TDV) is a significant public health problem, but we know little about how mothers who have been abused respond to TDV. This article analyzes qualitative data from three focus groups conducted with 17 mothers who had experienced abuse. Mothers responded to four hypothetical scenarios of their child reporting TDV to them. Mothers reported that their approach to children’s reports of TDV would entail engaging in varying levels of authoritarianism, considering the gender of the child, and exercising caution in their responses. In response to the scenarios, mothers stated that they would ask questions, educate their teens, contact the perpetrator and/or parents, share their own experiences, and call for outside help. The study’s findings may assist prevention educators working with mothers who experienced abuse in responding to their children’s disclosures of incidents of TDV.     

The assessment of drawings from children who have been maltreated: a systematic review

This paper presents a systematic review that aims to identify studies using drawing techniques with maltreated children. The paper first introduces the relevant developmental theory relating to children's drawings and its application to practice. Studies using drawing techniques with maltreated children were identified from both the research and practice literature. These were summarized and compared. The evidence from the studies appears relatively inconclusive as to the value of children's drawings for the identification of possible maltreatment, although they do apparently help in aiding recall of important events. Drawings are widely used to assess maltreatment and neglect of children. However, researchers advocate caution in generalizing and interpreting drawings from children with differing experiences. Copyright © 2002 John Wiley & Sons, Ltd.     

Needed services for foster parents of sexually abused children

Foster parents with little preparation and short notices must often deal with severe emotional and behavioral difficulties of sexually abused children. This article reports on a survey of the services provided to foster parents who care for sexually abused children in a large city in the Northeast United States. Agency directors, social workers and foster parents were asked to respond to mailed questionnaires. The results indicated that foster parents consistently reported that they received less extensive educational and support services than were reported by social workers and directors of foster care agencies. All groups recommend further expansion of training programs for foster parents of sexually abused children.This paper was presented at the Temple University Chapter, Phi Delta Kappa, Philadelphia, PA, April 5, 1990.Ms. Egan is a Research Assistant; Ms. Cossett and Ms. Auletta were studients from Smith College School for Social Work.     

Adolescent females who have sexually offended: comparisons with delinquent adolescent female offenders and adolescent males who sexually offend

Very little is known about adolescent females who commit sexual offenses. In this two-part exploratory study, a sample of 11 adolescent females with sexual offense histories is described. In Study I, the sample is compared to an age-matched sample of 11 adolescent females with non-sexual victim-involved offense histories. The sexually offending group had significantly fewer antisocial behavior problems, such as alcohol or drug use problems, problems with fighting, or problems at school. They began their offense behaviors at younger ages than their non-sex offending delinquent peers. Few differences emerged with respect to attitudes about offense behaviors, such as level of denial. In Study II, the same sample of females with sex offense histories was compared with a group of age-matched adolescent males with sex offense histories. The two sex-offending groups were found to be remarkably similar. There were few differences with respect to psychosocial and criminal histories, antisocial behavior, and variables related to clinical presentation and treatment (e.g., level of denial about offense). Likewise, the two groups are remarkably similar with respect to specific sex offense behaviors. The females, however, appear to have experienced more severe and pervasive abuse compared to the males.     

Treatment outcome research with the non-offending parents of sexually abused children: a critical review

Potentially deleterious effects arise from the experience of childhood sexual abuse, but maternal supportiveness has been identified as a crucial mediator. Consequently, a body of knowledge has begun to develop on interventions designed to improve the supportiveness and adjustment of the non-offending parent. The present paper attempts to provide a critical review of the treatment outcomes reported for these new interventions. Studies have been organized according to the sexually abused child's stage of development: preschool, school-aged, and adolescence. Recommendations for service delivery and research follow.     

Non-abusive mothers of sexually abused children. The role of rumination in maternal outcomes

This study of 125 mothers examined the role of rumination in maternal emotional and behavioral outcomes subsequent to discovery of the sexual abuse of their children. Abuse severity, a maternal history of child abuse experiences, and life hassles were examined as predictors of negative outcomes. The central finding was that these factors, many of which are not controllable, were less likely to predict poor maternal outcomes than was rumination, a cognitive process that may be alterable. Rumination was the strongest correlate with each outcome. Further, the effects of most predictors on outcomes in this study were mediated by a ruminative cognitive style. Abuse severity, income, ethnicity, and education lacked significant relationships with maternal outcomes. This study asserts that rumination is a central component for understanding maternal outcomes in the post-discovery phase of sexual abuse cases. It recommends that rumination be routinely assessed both for research and treatment purposes.     

Pivotal partings: Forced termination with a sexually abused boy

The termination phase of therapy is an integral part of the treatment process engendering its own unique set of dynamics. However, the potential eruption of new material dislodged by the trauma of the impending loss may in some cases require a reassessment of discharge goals and consequent alteration of treatment modality. The likelihood of new material surfacing at this critical juncture is perhaps highest among the caseloads of therapist trainees, wherein the termination date is forced by the time-limited nature of the learning contract. In the following article, supervisor and trainee detail the process of therapeutic shift from a dynamic to a crisis-oriented modality in the case of a young boy whose central trauma emerged during termination.