Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse

Child sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy’s evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group.     

Service Patterns of Adult Survivors of Childhood Versus Adult Sexual Assault/Abuse

This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the demographic characteristics, referral sources, and service patterns of the two groups. Results indicate that paths into service differ for the two groups. Furthermore, adult survivors of childhood sexual assault/abuse obtain significantly more hours of service and service contacts on average than adult survivors of adult sexual assault/abuse. Implications for policy and practice are discussed.     

The Nature of Posttraumatic Growth in Adult Survivors of Child Sexual Abuse

Potential negative sequelae for survivors of child sexual abuse is well documented. However, growing evidence suggests that some individuals who actively cope with traumatic events can progress from a negative trajectory toward positive psychological change, often termed posttraumatic growth. Current posttraumatic growth theories may be of limited applicability to developmental considerations involved in child sexual abuse. This explorative study examines posttraumatic growth among adult female survivors of child sexual abuse. In-depth interviews were conducted with six participants who believed they had grown through coping with their abuse. Data was analyzed using interpretative phenomenological analysis. Three superordinate and nine subordinate themes were identified and explored. Some participants reported experiencing growth and distress simultaneously. Theoretical and clinical implications are examined in relation to the study’s findings.     

Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA

ABSTRACT

This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence that the therapeutic benefits of EMDR for adult female survivors of CSA can be maintained over an 18-month period. Furthermore, there is some support for the suggestion that EMDR did so more efficiently and provided a greater sense of trauma resolution than did routine individual therapy.     

Psychologists' Attitudes Toward Adult Male Survivors of Sexual Abuse

ABSTRACT

Psychologists' attitudes toward adult male sexual abuse survivors were explored. Psychologists (n = 154) read vignettes describing the sexual abuse of a male victim, then completed the Male Role Norm Scale, the Jackson Incest Blame Scale, a vignette response sheet, and a personal data sheet. Stepwise regression was used to analyze the data. Variables included characteristics of the psychologists, the perpetrator, and the victim. The psychologists' attitudes toward men, rather than the sex of the psychologists, predicted blaming attitudes. Victim responses, sexual abuse treatment experience, and the severity of abuse were also predictors. Practical suggestions for treatment are noted.     

Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse

ABSTRACT

The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.     

The E.S.S.E. Group Model

Social work practitioners today are having to deal with ever-increasing numbers of families falling into the at risk category. At the same time, the issues and problems facing these family units are often overwhelming and challenging to resolve. The E.S.S.E. Group Model, outlined in this article, is a new research based approach that was designed to address the most relevant concerns facing families today. It is a unique program that combines family life education within a support group framework. Initially, the model was developed for several school districts in the midwest. Counseling personnel had identified a need for a parent training program that would elicit higher levels of participation. The E.S.S.E. Model accomplishes that goal through its structured yet individualized curriculum along with its parallel and conjoint group set-up. The specific content and process guidelines of this new approach make it easy for clinicians to duplicate in a wide variety of settings. One of the model's curriculums is outlined in detail in this article. Readers will find that the E.S.S.E. program serves as an excellent example of the type of group intervention needed today to help revitalize at-risk families.     

The Treatment of Adult Male Child Molesters Through Group Family Intervention

Abstract

This paper explores the effectiveness of treating the child molester in multiple contexts as opposed to in-group therapy alone. Research indicates that sexual abuse may stem from a combination of family dysfunction (Hanson et al., 1994) and further, that family members' decisions impact the therapeutic process (Lipovsky, 1991). These and other findings suggest that effective counseling of sexual offenders should include not only the perpetrator, but the family members as well. This paper outlines a current treatment program utilizing a group process of relapse prevention and cognitive behavioral therapy techniques in concert with a companion group for partners and a therapeutic nursery for preschool-aged children. Using archival data, this paper addresses the effectiveness of the program and highlights the usefulness of involving family members in the process.     

Perceptions of Childhood Sexual Abuse Survivors: Development and Initial Validation of a New Scale to Measure Stereotypes of Adult Survivors of Childhood Sexual Abuse

The Childhood Sexual Abuse Stereotypes Scale was developed to assess stereotypes of adult survivors of childhood sexual abuse. Scale items were derived from two studies that elicited cultural and personal beliefs about, and emotions experienced towards adult childhood sexual abuse survivors among university undergraduates. Two scales, Emotions and Characteristics, were developed and administered online to 182 participants. Exploratory factor analysis produced 7 factors, 4 for the Emotions Scale and 3 for the Characteristics Scale. Study 2 replicated this factor structure using confirmatory factor analysis (N?=?457). Reliability and validity analyses suggest that the Childhood Sexual Abuse Stereotypes Scale has satisfactory psychometric properties. The Childhood Sexual Abuse Stereotypes Scale can be used to examine stereotypes of legal and health care professionals likely to work with survivors as well as in stereotyping research.     

The Attachment Function of Acute and Chronic Suicidal Illness in the Psychotherapy of an Adult Female Incest Survivor

This paper presents the attachment-focused psychotherapy of a suicidal adult woman with a history of paternal incest, paternal suicide, and maternal death; the latter provoked the patient’s near lethal overdose. Psychotherapy with this patient posed formidable clinical challenges because killing herself represented the internalization of profound incest-related shame and pathological beliefs about herself and mother that permeated her whole way of being. By focusing on the patient’s multiple working models of attachment associated with the incest and father’s suicide, I illustrate the intergenerational transmission of unresolved trauma underlying her suicidal illness. The implications for practice emphasize how understanding and utilizing the intersubjective disorganized attachment dynamics facilitated the patient’s internalization of more adaptive and life-affirming views of self and surrounding conditions.     

An Editorial Planning for Health Services

Abstract

The field of administration and management has undergone a steady evolution since its origin at the turn of the century. A perspective regarding that development is useful to the health service administrator. This paper examines and interprets selected writings in administration and management. The appropriateness of this open-communication model to medical settings is demonstrated and the application of this model to a specific student health service is described and discussed.     

Applied Restorative Justice as a Complement to Systemic Family Therapy: Theory and Practice Implications for Families Experiencing Intra‐Familial Adolescent Sibling Incest

This article considers the impact on and therapeutic responses to families where there has been intra‐familial sexual assault (IFSA) by an adolescent member of the family against another younger member of the family. In doing so, the article will specifically highlight the nexus between systemic family therapy ideas and an applied restorative justice response in the form of Youth Justice Conferencing (YJC), as experienced through working as a family therapist in the area of adolescent sexual offending.     

Mild Intellectual Disability Associated with a Progeny of Father-Daughter Incest: Genetic and Environmental Considerations

We report the case of a 34-year-old female resulting from a father-daughter sexual abuse and presenting a phenotype of mild intellectual disability with minor dysmorphic features. Karyotyping showed a normal 46, XX constitution. Array-based comparative genomic hybridization (array-CGH) revealed a heterozygote 320kb 6p22.3 microdeletion in the proband, encompassing only one known gene, and therefore unlikely to be the cause of the phenotype. However, the role of other genetic factors, such as a recessive condition, could not be ruled out as a putative cause for the phenotype. On the other hand, the role played by a heavily detrimental familial situation on the development and outcome, and possibly leading or contributing to a mild intellectual disability, should be taken into account.     

Acute Stress Disorder Symptoms Among Female Sexual Abuse Survivors Seeking Treatment

ABSTRACT

This exploratory study examined relationships between acute stress disorder (ASD) symptoms and sexual abuse history, distress, and social support among sexual abuse survivors seeking treatment. Participants were 32 women recruited for a pilot study of group treatment for sexual abuse survivors who completed self-report and interview measures. Many participants (37.5%) met criteria for all ASD symptoms. Also, ASD symptoms were significantly related to seeing the self as the causal locus of the abuse, forgetting the abuse for a period of time, and the number of abusers, the distress of a recent life event, other forms of distress, and poor social support, Acute stress disorder may occur among many sexual abuse survivors seeking treatment, requiring special intervention to help these patients to manage their reactions to ongoing stresses.     

A Study of Shame from Sexual Abuse Within the Context of a Norwegian Incest Center

Working with those who have experienced sexual abuse is a complicated matter because such abuse not only involves the violation of the victim's body, but it often generates shame in those involved. This article is based on empirical data from 26 hours of videotaped focus group interviews with 19 adult men and women in a Norwegian incest center who spoke openly of the shame they experienced from sexual abuse as children, parents, and employees. Findings from this study show that shame from sexual abuse can be grouped into seven major categories: (a) family, (b) emotions, (c) body, (d) food, (e) self-image, (f) sex, and (g) therapy.     

Group Therapy for Survivors of Severe Childhood Abuse: Repairing the Social Contract

ABSTRACT

This article presents a model for conducting time-limited group therapy with adult survivors of severe childhood abuse who are diagnosed with complex post-traumatic and dissociative disorders. While difficult to engage in mixed groups, these clients can succeed in structured, homogeneous groups focused on responsible participation, social connection and symptom management. Group sessions are organized around verbal promises, “social contracts,” that encourage the client's active, attentive engagement. Gentle confrontation of dissociative defenses is integral to the success of each session. Group guidelines, the provision of structure, and common themes are explained, as are the group therapist's complicated countertransference responses to these clients.     

Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

This pilot study was conducted to examine older child molestation victims' self-report of their long-term psychological adjustment at least 12 months after the date of their initial clinic evaluation. Female participants were assesed using the Piers-Harris Children's Self-Concept Scale, Children's Depression Inventory, and the Hopelessness Scale which were also administered during their first evaluation. T-ratios revealed that scores on all measures, including five of the six Piers-Harris subscales showed significant improvement. The high rate of noncompliance associated with this population is also discussed in terms of removal from the home, type of abuse, and age of the perpetrator.