Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child Advocacy Center participated in the study. Results indicate that children in the groups that included therapy dogs showed significant decreases in trauma symptoms including anxiety, depression, anger, post-traumatic stress disorder, dissociation, and sexual concerns. In addition, results show that children who participated in the group with therapeutic stories showed significantly more change than the other groups. Implications and suggestions for further research are discussed.     

A Behavioral Group Treatment Program for Sexually Dysfunctional Couples*

A behavioral treatment program, previously effective with individual couples, was designed for a group setting. Four couples were treated in a group format for primary inorgasmic dysfunctions and premature ejaculation. Results indicated a high degree of success. This preliminary study, then, suggests that group treatment for sexually dysfunctional couples can be an effective treatment mode with specific advantages over individual therapy. Several possible problems with this treatment mode were discussed, including the possibility that the overall reinforcement value of the group process was underestimated. This variable should be carefully examined by other therapists utilizing group treatment procedures for couples with sexual dysfunctional problems, along with continuing efforts to reduce treatment time.     

Providing sexual education to victims of child sexual abuse:what is a clinician to do?

Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.     

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.     

Variables Associated with Positive Treatment Outcomes for Children Surviving Sexual Abuse

This exploratory study examined variables associated with positive treatment outcomes for 47 children who received sexual abuse treatment. Variables associated with a higher percentage of treatment objectives accomplished were: services provided to the pre-adolescent child; child resided at home; perpetrator was criminally charged; support by non-offending caretaker currently and at disclosure; individual, family and group therapy were provided, and termination of services was planned. Variables associated with a positive placement outcome were: services provided to the pre-adolescent child; abuse did not involve body penetration; child resided at home; child was never removed from home; services were not court-ordered; and termination was planned. A higher percentage of applicable treatment objectives accomplished was significantly correlated with a positive placement outcome.     

An Evaluation of a Group Treatment for Sexually Abused Young Children

ABSTRACT

The present study measured outcomes of a group treatment for five-to eight-year-old sexually abused children. Although research completed in the last 10 years has produced some outcome studies on the effectiveness of group treatment for this population, no previous research has measured the effectiveness of psychoeducational interventions, such as the teaching of sexual information and abuse prevention strategies which are often included in this type of treatment. Also, the effects of different lengths of treatment have not been studied. The results of the current study found that children improved significantly from pre-treatment to mid-treatment on measures of problematic behavior, sexual information and abuse prevention. The children also made significant improvements from mid-treatment to post-treatment and from pre-treatment to post-treatment on all of the outcome measures with the exception of mid-treatment to post-treatment changes on the maternal acceptance self-esteem subscale. These results suggest that young children do benefit from a sexual abuse group treatment and that a longer treatment may be more beneficial.     

Sexual abuse: Effects of group therapy on pre-adolescent girls

This article describes the effectiveness of a group therapy program used at the University of Manitoba with pre-adolescent girls who have experienced sexual abuse. Thirty-five girls, ranging in age from 7 to 12, were referred to structured therapy groups of 9 to 12 weeks' duration. Issues addressed in weekly sessions included feelings about the offender, problem-solving, sex education, and prevention of further abuse. Measurements of self-esteem, anxiety, and internalizing and externalizing behaviour problems were taken for participating children prior to and following treatment at 1 and 9 to 12 month intervals. Parent- and child-reported social validity data were also collected following treatment. Comparison group data for self-esteem and anxiety were provided by a non-random sample of 35 girls with no known history of sexual abuse. Results indicated that following group therapy, self-esteem increased and anxiety and behaviour problems decreased. Comparison group data further supported the effectiveness of group treatment in improving the self-esteem of sexually abused girls. Social validity reports of children and parents also suggested that treatment was helpful and worthwhile. Implications of the findings are discussed as are difficulties encountered in conducting treatment outcome research with children who have been sexually abused.     

Group Treatment of Latency-Age Male Victims of Sexual Abuse

Researchers and clinicians across the country have documented increases in reports of sexual victimization of males. Awareness of the immediate and long-term needs of young male victims has highlighted the need for specialized, multi-modal treatment programs for these youngsters. Group therapy can be an important adjunct to individual and family unit therapy with this population. This article provides concrete suggestions for developing, implementing and evaluating a group therapy program for young male victims of sexual abuse. Specific areas addressed include: selection and preparation of group members; structure, phases, and salient tasks of the group; therapeutic group activities; co-leadership issues; managing transference and countertransference in the context of group; and, methods for evaluating the group's effectiveness.     

Child Advocacy Center Based Group Treatment for Child Sexual Abuse

The present study examines initial symptom presentation among participants, outcomes, and social validity for a group treatment for child sexual abuse delivered at a child advocacy center. Participants were 97 children and their nonoffending caregivers who were referred to Project SAFE (Sexual Abuse Family Education), a standardized, 12-week cognitive-behavioral group treatment for families who have experienced child sexual abuse. Sixty-four percent of children presented with clinically significant symptoms on at least one measure with established clinical cutoffs. Caregivers of children who presented with clinically significant symptoms reported more distress about their competence as caregivers. Children who presented as subclinical were more likely to have experienced intrafamilial sexual abuse. Posttreatment results indicated significant improvements in functioning for all children who participated in treatment, with greater improvements reported for children who initially presented with clinically significant symptoms. Overall, the program was rated favorably on the posttreatment evaluation of social validity.     

Forensic Interviews for Child Sexual Abuse Allegations: An Investigation into the Effects of Animal-Assisted Intervention on Stress Biomarkers

The use of therapy animals during forensic interviews for child sexual abuse allegations is a recommendation by the Therapy Animals Supporting Kids Program to help ease children’s discomfort during the forensic interview process. Based on this recommendation, this study incorporated a certified therapy canine into the forensic interview process for child sexual abuse allegations. This study investigated changes in salivary cortisol, immunoglobulin A, blood pressure, and heart rate as a result of forensic interview phenomenon (e.g., outcry) incorporating animal-assisted intervention versus a control condition in children (N = 42) interviewed for alleged child sexual abuse. The results supported significantly greater heart rate values for the control group (n = 23) who experienced sexual contact and/or indecency than the experience of aggravated sexual assault compared to no difference in HR for the intervention group (n = 19). The results suggest that the presence of the canine in the forensic interview may have acted as a buffer or safeguard for the children when disclosing details of sexual abuse. In the intervention group, children’s HR was lower at the start of the forensic interview compared to the control group. Finding an effect of having a certified handler–canine team available during the forensic interview on physiological measures of stress has real-world value for children, child welfare personnel, and clinical therapists. It is suggested that animal-assisted intervention be expanded to children facing other types of trauma and to treatment programs for child survivors of sexual abuse.     

THE "ALIENATED" PARTNER: RESPONSES TO TRADITIONAL THERAPIES FOR ADULT SEX ABUSE SURVIVORS

Childhood sexual abuse affects both survivors and partners; however, the common therapy modalities for survivors (individual and individual group therapy exclude their partners. In-depth interviews with the husbands of survivors were used to examine partner issues around the survivor's therapy. Several thems, both positive and negative, emerged from the qualitative analysis of the in-depth interviews. The authors suggest that therapists should consider integration conjoint couple therapy as an adjunct to, not a replacement for the traditional modalities of individual and individual group therapy for adult survivors.     

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.     

Treatment Experiences of Child Sexual Offenders in Norway: A Qualitative Study

This article is an attempt at gaining a better understanding of treatment of adults who have committed sexual offenses against children. In this study we aimed to explore what people who have committed sexual offenses against children find useful in therapy. The study was approached using qualitative methodology, and information was collected through semistructured interviews. Four male child sexual offenders were recruited from the Institute of Clinical Sexology and Therapy in Oslo, Norway. The informants were interviewed with a focus on what factors they found useful in therapy. Through an explorative, thematic analysis, five main themes were found. These themes include: “Why I started going to therapy,” “Why did I do it?” “Therapy as life,” “Previous and current relationships with others,” and “I lived in a fantasy world where everything was okay.” Based on this study and other earlier studies and theories it appears that the previously mentioned themes recur as important contributory factors in the treatment of child sexual offenders.     

Caregiver Needs Following Disclosure of Child Sexual Abuse

Caregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children’s needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.     

Treatment for Juveniles Who Sexually Offend in a Southwestern State

A 25-item questionnaire was mailed to sex offender treatment providers from counties with 60 or more reported juvenile sex offenders in a Southwestern state to determine the most effective treatment for juvenile sex offenders. Results indicated that cognitive behavioral therapy was the most successful reported approach to treatment with an average success rate of 87%. The most commonly used approach was cognitive behavioral therapy with relapse prevention. The most common sexual offense was indecency with a child involving sexual contact, contrary to studies that found that in the Probation Commission data, aggravated sexual offense was the most common. These results have ramifications for state policies on treatment for juvenile sex offenders.     

Discovering an integrated framework for practice: a qualitative investigation of theories used by social workers working as sexual abuse therapists

In this article, I explore the historical background and context to the theoretical eclecticism described by the participants interviewed for a research study. The initial aim was to test the relevance of the vicarious traumatisation (vt) or vt literature with a group of sexual abuse therapists. The participants interviewed were all working as sexual abuse therapists in group and individual practices, many of whom worked in the field before there were well articulated theories of trauma assessment and treatment in the 1970s and 1980s. With the available theory, they actively developed their own unique frameworks for practice and became pioneers in the field. The findings of this research suggest that the practitioners' reference to diverse sources of theory is both a resource and protective factor which, when synthesised, is drawn upon to support the day-to-day work of sexual abuse therapy.     

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.     

Sexual Abuse Images in Cyberspace: Expanding the Ecology of the Child

Cyberspace has added a new dimension to the ecology of children made the subjects of sexual abuse images distributed online. These images cannot be permanently removed and can continue to circulate in cyberspace forever. A review of the current literature suggests that helping professionals are not consistently aware of or do not probe possibilities of online sexual victimization in the investigation, assessment, and treatment of child sexual abuse. Nor is this issue adequately addressed in their education and training. There are gaps in the literature regarding how to identify and provide treatment for these children. New assessment and treatment targets are needed to enhance existing practice approaches. A contemporary ecological model that incorporates an explicit consideration of the cybersystem is provided as a starting point for practitioners to be aware of the possibility that images of child sexual abuse were recorded and distributed online.