Efficacy of a Group Therapy for Sexually Abused Adolescent Girls

ABSTRACT

The effects of a group therapy program for teenage girls reporting child sexual abuse were evaluated by means of a pretest/post-test design with a control group. The psycho-educational intervention consisted of an average of 20 weekly two-hour meetings. Results of the repeated analyses of variance (ANOVA) revealed a sig-nificant improvement in youth participating in the therapy when compared with the control group on measures of post-traumatic stress, internalizing and externalizing behavior problems, coping strategies, relation- ship with the mother, and sense of empowerment. The findings suggest that the group therapy offered by the Centre d'Intervention en Abus Sexuels pour la Famille (CIASF) was effective in reducing symptoms for sexually abused teenagers.     

Multi-Family Group Therapy for Sexually Abusive Youth

SUMMARY

Although Multi-Family Group Therapy (MFGT) has been a researched intervention for nearly 40 years, clinicians working with sexually abusive youth and their families have only more recently begun to utilize the intervention. We believe MFGT for a sexual offense-specific treatment population is a sophisticated and powerful clinical intervention with unique advantages including economical use of clinician resources, family-to-family transfer of knowledge and mentoring, community-based resourcefulness, and accelerated catalyzing of emotions. This article will provide direction on establishing the MFGT format as well as discuss its goals, curriculum, facilitation priorities, and strategies.     

Current Practices in Residential Treatment for Adolescent Sex Offenders: A Survey

SUMMARY

A list of all treatment facilities for adolescent sex offenders that described themselves as inpatient or residential was requested from the Safer Society Foundation in Brandon, Vermont. A total of 203 such facilities were identified in this manner. Each was sent a questionnaire regarding their policies and practices. Of the 50 questionnaires that were returned, 49 were usable. Items on the questionnaire dealt with major phases of operating a residential program, including number of beds, average daily census, number of males and females in treatment, testing and assessment procedures, most frequent diagnoses, average IQ of patients, abuse history, therapeutic approaches used, number and types of individual/group treatment sessions per week, qualifications of therapists, average length of treatment, and follow-up research on treatment.     

A Safe Place for Predators: Online Treatment of Recovering Sex Offenders

ABSTRACT

This study examines the process and effectiveness of a voluntary online support group for recovering sex offenders. The study used unobtrusive observation of the group for a period of 10 months. The support group was facilitated by two nonprofessional, recovering sex offenders. The group was found to be a positive therapeutic environment, with members providing positive support and confrontation through the process of change. Among those who were active participants, there was significant improvement in several indicators of change.     

The Lived Experience of the Adolescent Sex Offender: A Phenomenological Case Study

Treatment for adolescents with sexually maladaptive behaviors is a continuing intervention that is changing and developing as greater understanding about this population of adolescents is obtained. The majority of treatment programs for adolescent sexually maladaptive behavior contain programming components that include cognitive distortions/thinking errors. Interviews including a conceptual mapping exercise were conducted with four adolescents adjudicated to a secure care program for sexual behaviors. All four boys completed an interview and a conceptual map of their perceived experiences as an adolescent with sexual maladaptive behaviors. All interviews were audio recorded. Analysis of the interviews and conceptual mappings yielded five themes present in the boys’ experience as well as a consideration of the role early trauma may have in the establishment of cognitive distortion development. Contributing environmental and familial factors also play an important part in sustaining cognitive distortion. Main themes include: loss of responsible father or father figure, inability to regulate emotion, lack of personal and parental boundaries, and early exposure to pornography. The contributing influence of responsible male father figures may play an even greater role in the lives of young males than originally thought. How the adolescent inaccurately perceives his environment—in essence what he tells himself and continues to tell himself to make sense of his world—are building blocks in the development and continuation of thinking errors/cognitive distortions used to commit and justify sexual offending behaviors.     

Eating Disordered Behaviors and Body Disapproval in Adolescent Males Adjudicated for Sexual and Nonsexual Crimes

Using a large sample of adjudicated delinquent male youth (N = 696), we compared data from youth who had been adjudicated for sexually aggressive crimes and those who had been adjudicated for nonsexual offenses on eating dysfunction, body disapproval, history of sexual abuse, and pornography exposure. The sample included 526 (75.8%) youth adjudicated for sexual offenses and 170 (24.4%) youth adjudicated for nonsexual crimes. The average age of the sample was 16.8 years (SD = 1.6), and approximately half of the sample (47.7%, n = 310) self-identified as White. The results of hierarchical multiple regressions indicated that sexually aggressive youth scored significantly higher than nonsexually offending youth on both eating dysfunction and body disapproval measures. Pornography exposure and substance use predicted body disapproval and eating dysfunction in the entire sample of adjudicated youth. History of sexual abuse was a significant predictor of body disapproval in all adjudicated youth but was not a significant predictor of eating dysfunction. Implications for research and practice are offered.     

Scale for the Identification of Acquaintance Rape Attitudes

SUMMARY

Within the context of intimate interpersonal relationships, gender-based violence has a significant impact on the social-emotional functioning and development of women. Our ability to determine the effectiveness of our efforts to reduce sexual violence is linked to our ability to assess those attitudes that condone sexual violence. This study examined the validity of college students' responses to the Scale for the Identification of Acquaintance Rape Attitudes (SIARA). The Scale for the Identification of Acquaintance Rape Attitudes is a measure designed to assess attitudes that are believed to be supportive of sexual violence within dating relationships. The sample consisted of 1,782 residential students in the first year class at a large, public university who participated in a sexual assault prevention program as part of a new student orientation. Exploratory and confirmatory factor analysis demonstrated that two dimensions, Sexual Expectations and Rape Mythology, could be used to characterize students' responses. Multi-group confirmatory factor analysis and mean structure analysis confirmed that the two dimensions provided equivalent measurements of the underlying construct for male and female subjects. Implications for the use of SIARA as a program outcome measure will be discussed.     

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Preliminary Investigation

This preliminary investigation examined the efficacy of a game-based cognitive-behavioral therapy group program for elementary school-aged children who have experienced sexual abuse. Treatment aimed to improve: (a) internalizing symptoms, (b) externalizing behaviors, (c) sexually inappropriate behaviors, (d) social skills deficits, (e) self-esteem problems, and (f) knowledge of healthy sexuality and self-protection skills. Results indicate that game-based cognitive-behavioral therapy was effective for improving internalizing and externalizing symptoms, reducing sexually inappropriate behaviors, and improving children's knowledge of abuse and self-protection skills. Although results pointed in a positive direction for social skills and self-perception, these findings were not statistically significant. Clinical significance was also evaluated to assess the clinical utility of treatment effects. Treatment implications of the findings and future research directions are discussed.     

‘Somebody Else's Roadmap’: Lived Experience of Maudsley and Family‐based Therapy for Adolescent Anorexia Nervosa

The Maudsley and more recent family‐based therapy manualised approaches are positioned by some as the gold standard, evidence‐based therapy for adolescent anorexia nervosa (AN). However, a significant proportion of adolescents and their families either discontinue this therapy and/or find that it simply does not work for them. These adolescents and families are under‐represented in the literature on therapeutic interventions for adolescent AN. This paper begins to address this gap with an in‐depth qualitative case study that explores the lived experience of Maudsley family therapy (MFT)/family‐based therapy (FBT) for one female adolescent (age 14 years) and her family over the period of 3 years (ages 11–14). Although initially handing over the responsibility for her eating was comforting and reinstated a sense of control in the family system, these experiences were not maintained. When she did not progress past the first phase of FBT, she and her family experienced the approach as blaming. She felt silenced and family alliances were weakened. This paper analyses how the family members negotiated and preserved their identities within this disabling context.     

Frequency of Group Sex Participation and Risk for HIV/STI Among Young Adult Nightclub Scene Participants

Objectives: This study examines frequency of group sex participation and associated characteristics and behaviors among a sample of heterosexual young adult participants in Miami's nightclub scene (n = 498). Methods: Baseline survey assessments were analyzed using zero-inflated binomial regression. Results: Forty-one percent of the sample reported group sex participation history. Greater frequency of group sex is associated with buying sex, sex with an injection drug user, being high during sex, condomless vaginal sex, victimization history, and sexually transmitted infection incidence (p < .02). Conclusions: Sexually transmitted infection prevention and intervention efforts should address risks associated with group sex participation.     

Group Cohesion and Homework Adherence in Multi‐Family Group Therapy for Schizophrenia

This study examined the relationship between levels of group cohesion, defined as whole group relationships, and between‐session therapeutic homework adherence in a multi‐family group therapy (MFGT) for people with schizophrenia. Participants from 18 consenting families attending MFGT groups completed weekly homework adherence ratings, group cohesion and spontaneous between‐session activity measures. Levels of group cohesion at each session were compared with measures of scheduled and spontaneous homework adherence reported at the next session. It was hypothesised that higher levels of group cohesion would be related to homework adherence and other spontaneous between‐session therapeutic activity completed by group members. Results show higher levels of group cohesion were associated with higher rates of spontaneous between‐session therapeutic activity. However, contrary to expectations no significant relationship between cohesion and scheduled homework completion was found. The implications of the findings for group processes and homework adherence are discussed.     

Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended. The model proved effective for treating young female victims of sexual abuse.     

The Children's Depression Scale in Family Therapy: Hearing the Hurt

In this article I review the changes in thinking about childhood depression since the 1950s, with an emphasis on the struggles to find language for childhood depression. My interface with these changes is described, with a particular focus on the development of the Children's Depression Scale (CDS). Clinical applications of family therapy using the CDS in treatment of childhood depression are then illustrated with a composite case example. The idea is developed that depression in children can be seen as a blocked communication, and that increasing emotional expressiveness in families is an appropriate therapeutic aim and intervention. The relevance of the historical context to current practice is considered.     

Adolescent Self‐cutting: An Embodiment of the Unsaid

This paper describes adolescent self‐cutting from a systemic–relational standpoint utilising two key concepts: embodied mind and the unsaid. Varella's notion of embodiment is introduced to understand the body as a field of meaning and the unsaid is conceptualised as what holds ‘said meaning’ and gives a sense of identity. These ideas are illustrated by reflections on a clinical vignette.     

The Experience of Trauma Recovery: A Qualitative Study of Participants in the Women Recovering from Abuse Program (WRAP)

ABSTRACT

The efficacy of intensive group treatment programs for child maltreatment has been established. The aim of this qualitative study was to understand how women with a history of child maltreatment experienced the Women Recovering from Abuse Program (WRAP), an existing intensive group treatment program. Seven women were interviewed following their participation in WRAP. Three themes emerged: Breaking Trauma-Based Patterns, Doing Therapy, and The Healing Journey as a Continuous Process. These findings deepen our understanding about how participants view the recovery process. Theoretical and clinical implications are discussed.     

An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

ABSTRACT

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11–16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.     

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Three-Month Follow-Up Investigation

This study examined the efficacy of a game-based cognitive-behavioral group therapy program for addressing problems typically found among elementary school-aged victims of child sexual abuse immediately after treatment and at three months following treatment. It was hypothesized that positive gains would be observed among the following domains: (a) internalizing symptoms (e.g., anxiety, depression, and trauma); (b) externalizing behaviors (e.g., oppositional behavior, disobedience, and conduct disordered behavior); and (c) sexually inappropriate behaviors. Improved knowledge of abuse and personal safety skills was also predicted. Results indicated that game-based cognitive-behavioral group therapy resulted in improvements in internalizing symptoms, externalizing behavioral problems, total behavioral problems, and personal safety skills both immediately after treatment and at three-month follow-up.     

Adolescent love and well-being: the role of dating relationships for psychological adjustment

Love has been identified as one of the most important aspects of interpersonal strength. During adolescence, the main social contexts in relation to love are friendships and dating relationships. The aim of this study was to measure the link between romantic relationship experience and personal adjustment, taking into account effects of age and sex, and to analyse the effect of adolescent dating relationship quality on personal adjustment. A total of 3258 Spanish adolescents were surveyed. The results indicated that dating status does not affect adolescent self-esteem, but has a significant effect on internalizing and externalizing behaviours and sexist beliefs. Regarding relationship quality, those adolescents who had a very good-quality relationship reported higher levels of psychological adjustment in terms of the variables measured. Results are discussed according to their utility for positive social development and its links to dating relationship quality during adolescence.     

Problem Gambling Among Adolescent Students in the Atlantic Provinces of Canada

The objectives of the present study were to determine the prevalence of problem gambling among adolescent students in the Atlantic provinces of Canada, and to determine the role of age and deception about legal age status as potential risk factors for problem gambling. In 1998, a total of 13,549 students in grades 7, 9, 10 and 12 in the public school systems of the four Atlantic provinces completed a self-reported anonymous questionnaire that included the South Oaks Gambling Screen-Revised for Adolescents. About 8.2% and 6.4% of adolescent students met the broad definition of at-risk and problem gambling, respectively. About 3.8% and 2.2% of adolescent students met the narrow definition of at-risk and problem gambling, respectively. The prevalence of problem gambling did not vary according to age. Using a fake identification or lying about one's age was found to be an independent risk factor for problem gambling. Playing video gambling machines was the gambling activity associated with the single greatest independent risk of using a fake identification or lying about one's age. It was concluded that deception about legal age status may be a facilitating factor permitting adolescents to gamble to the point of experiencing problems.     

Rape Protests in India and the Birth of a New Repertoire

The gang rape of a young physiotherapy student on a moving bus in December of 2012, in Delhi, India, brought forward a series of countrywide protests. These protests were unique compared with prior protests in India, leading to a need to re-examine the political importance of social movements in the subcontinent. Using data from 748 newspaper reports on the demonstrations that took place from December 2012 to April 2013, this paper examines the unique characteristics of the rape protests and their implications on the birth of a new repertoire in social movements. For the first time in Indian history, women's rights and violence against women occupied the forefront of national politics, and was no longer limited to agendas of feminists and women's groups. The protests were not led by a specific interest group, but were spontaneous and horizontal in nature, with participants from various social and political backgrounds. This paper argues that with the help of technology and new social media that a new repertoire of protests emerged: a horizontal, spontaneous, mass movement across interest groups.