Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Female Offenders in Child Sexual Abuse Cases: A National Picture

Female sexual offenders are significantly underrepresented in the literature. Largely due to a failure of our society to recognize women as offenders, we allow them to avoid detection, prosecution, and interventions like tracking, registration, or mandated treatment. This could be partially due to differences that exist in their offending behaviors, victim profiles, and personal characteristics that set them apart from male offenders, to whom our systems have become more attuned. This article features an examination of virtually every substantiated child sexual abuse case reported to child protective services in the United States for 2010. Findings detail observed differences between male and female offenders on multiple domains and affirm female sexual offenders to be distinctly different from their male counterparts.     

Holocaust Child Survivors and Child Sexual Abuse

ABSTRACT

This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Child Sexual Abuse in Zimbabwe

Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.     

Obfuscating Child Sexual Abuse I: The Identification of Social Problems

Despite the increase in public knowledge about the existence of child sexual abuse, caused by public inquiries, media attention and the significant number of publications on the subject, the problem of child sexual abuse has failed to be systematically addressed as a policy problem. It appears that neither the public nor the government has been convinced that child sexual abuse is a serious problem which is common, persistent and widespread across the dimensions of race, ability and social class. This paper examines the factors which enable child sexual abuse to be obfuscated, that is, obscured and hidden. © 1997 by John Wiley & Sons, Ltd.     

Child Sexual Abuse: Community Concerns in Urban Tanzania

The aim of this study was to explore community perceptions about child sexual abuse in Tanzania. Thirteen focus group discussions were conducted with adult community members. The core category, children's rights challenged by lack of agency, was supported by eight categories. Aware but distressed portrayed feelings of hopelessness, lack of trust in the healthcare and legal systems reflected perceived malpractice, decreased respect for children's rights referred to poor parental care and substance abuse, myths justifying CSA illustrated cultural beliefs to rationalize child sexual abuse, disclosure threatened by fear of stigma and discriminationaligned the manifestations that prevent disclosure, actions driven by economic circumstances described the economical dependence of victims, urging a change in procedures reflected informants' wish to ally with local governance and pressure groups, and willingness to act indicated the community's role in supporting victims. The study showed how lack of agency calls for efforts to increase children's human rights at all levels.     

Prevention of Child Sexual Abuse by Targeting Pre-Offenders Before First Offense

The population of potential child abuse offenders has largely been unstudied. In the current study, we examine whether a six-component model used for primary diabetes prevention could be adapted to child sexual abuse pre-offenders, whereby individuals who are prone to sexual abuse but have not yet committed an offense can be prevented from committing a first offense. The six components include: define and track the magnitude of the problem, delineate a well-established risk factor profile so that at-risk persons can be identified, define valid screening tests to correctly rule in those with the disease and rule out those without disease, test effectiveness of interventions—the Dunkelfeld Project is an example, produce and disseminate reliable outcome data so that widespread application can be justified, and establish a system for continuous improvement. By using the diabetes primary prevention model as a model, the number of victims of child sexual abuse might be diminished.     

Reporting Child Sexual Abuse within Religious Settings: Challenges and Future Directions

The sexual abuse of children within religious settings is an issue that has gained increased popular and professional attention over the past two decades. Various reports have highlighted the scale of such abuse, along with shortcomings in reporting practices. In this article, we outline some contemporary research that sought to understand the psychology that underpins variable reporting practices. In line with this research, we set out two conceptual frameworks that have some potential to help to explain such practices: system justification theory and moral foundations theory. Further, we describe how these frameworks could be adopted in research moving forward in order to make sense of the ways in which members of religious groups respond to allegations of child sexual abuse within their institutions. We close the article by arguing that by gaining a deeper understanding of the psychology underlying reporting practices, it may be possible to communicate more effectively about child sexual abuse within religious institutions, and therefore encourage more widespread reporting of allegations before more children are harmed.

‘We outline some contemporary research that sought to understand the psychology that underpins variable reporting practices’

Key Practitioner Messages

• Those most likely to observe or suspect child abuse in religious settings are themselves likely to participate in such settings.
• The challenge for these ‘onlookers’ is to overcome the psychological dynamics that push against the recognition and reporting of child abuse in religious settings.
• These dynamics can be understood via established psychological theories and frameworks.
• Practitioners concerned with improving reporting practice in these contexts can draw on this work to inform training and intervention strategies.

     

The Diagnostic Utility of the Child Sexual Behavior Inventory for Sexual Abuse: A Systematic Review

Children with alleged child sexual abuse (CSA) need to be assessed systematically. The use of validated instruments during the assessment, like the Child Sexual Behavior Inventory (CSBI), could add diagnostic value. We aim to assess the diagnostic utility of the CSBI to differentiate between sexually abused and non-abused children. We conducted a systematic review. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI scores in sexually abused children and non-abused children (2–12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included 7 (out of 1048) articles. The CSBI total scores were significantly higher in CSA-victims compared with non-abused children (in case–control settings). However, in children with suspected CSA, the results were ambiguous. One study reported significant differences. Another study reported weak diagnostic ability for the CSBI-3 in children with suspected CSA (a sensitivity and specificity of 0.50, with a positive predictive value of 0.28, and a negative predictive value of 0.72). Research on the diagnostic utility of the CSBI for suspected CSA is limited and shows disappointing results. Until more research is done, the CSBI should not be used on its own to differentiate between sexually abused and non-abused children.     

Obfuscating Child Sexual Abuse II: Listening to Survivors

The reality of the extent and experience of child sexual abuse cannot be revealed while children are unable to ‘stand up and be counted’. Limited alternatives, lack of information and dependence on adults prevent the true scale of the problem being appreciated. Similarly, media and legal treatment of abused children also operate to suppress the truth. The expertise and knowledge of those who have suffered abuse need to be acknowledged and utilized in order that child sexual abuse can no longer be obfuscated. © 1997 John Wiley & Sons, Ltd.     

Prevention of Child Sexual Abuse: Analysis and Discussion of the Field

Prevention of child sexual abuse is complicated, challenging, and highly necessary as sexual abuse of children and youth represents an extensive problem across the world. This article reviews the existing preventive interventions targeting children, parents, and professionals. An alternative way of organizing the child sexual abuse prevention research literature is offered and applied with emphasis on three areas: (a) child sexual abuse prevention interventions, (b) meta-analyses of child sexual abuse prevention interventions, and (c) general theoretical models about prevention and the child. Based on an analysis of these areas, it was found that there was a lack of connection between theoretical models and concrete preventive interventions. An overview of current challenges and future possibilities in this area is provided.     

Evaluating Allegations of Child Sexual Abuse Within Complex Child Custody Cases

SUMMARY

This article provides a framework for identifying and assembling the interdependent elements of a child custody evaluation with allegations of child sexual abuse. The identification of several myths regarding child sexual abuse (CSA) introduces the subject matter of this article. A forensic evaluation model (Heilbrun, 2001) is then used to organize the custody evaluator's tasks into the following sequential classifications: (a) preparation; (b) data collection; (c) data interpretation; and (d) communication of results. Through this model, the entwined tasks of evaluating the child's needs and the parents' capacities to meet the child's needs, while simultaneously examining the question of child sexual abuse, are addressed.     

The Construct of Grooming in Child Sexual Abuse: Conceptual and Measurement Issues

There have been claims that some child molesters engage in a “seduction stage” prior to committing abuse. These behaviors, commonly known as “grooming,” are understood as methods child molesters use to gain access to and prepare future victims to be compliant with abuse. However, there is a lack of consensus regarding exactly what this process entails and how it is clearly distinguished from normal adult–child interactions. It is important to devise an accurate definition of grooming for scientific, clinical, and forensic purposes. We critically evaluate the various definitions and reveal problematic heterogeneity. Furthermore, there are no methods of known psychometrics to validly assess grooming. We review the empirical literature regarding the occurrence of grooming and propose future directions for research.     

Preventing Child Sexual Abuse: Body Safety Training for Young Children in Turkey

The “Body Safety Training Program” is an education program aimed at ensuring children are informed about their body and acquire self-protection skills. In this study, a total of 83 preschoolers were divided into experimental and control groups; based on a power analysis, 40 children comprised the experimental group, while 43 children comprised the control group. The “Body Safety Training Programme” was translated into Turkish and content validity was determined regarding the language and cultural appropriateness. The “What If Situations Test” (WIST) was administered to both groups before and after the training. Mann–Whitney U Test, Kruskal–Wallis Variance Analysis, and the Wilcoxon Signed Ranks Test were used to compare between the groups and the Spearman correlation analysis was used to determine the strength of the relationship between the dependent and independent variable. The differences between the pretest and posttest scores for the subscales (appropriate recognition, inappropriate recognition, say, do, tell, and reporting skills), and the personal safety questionnaire (PSQ) score means for the children in the experimental group were found to be statistically significant (p < .001). The posttest–pretest difference score means of the experimental group children for WIST saying, doing, telling and reporting, total skills, and PSQ were found to be statistically significant as compared to that of the control group (p < .05). The “Body Safety Training programme” is effective in increasing the child sexual abuse prevention and self-protection skills in Turkish young children.     

Outcry Consistency and Prosecutorial Decisions in Child Sexual Abuse Cases

This study examines the correlation between the consistency in a child’s sexual abuse outcry and the prosecutorial decision to accept or reject cases of child sexual abuse. Case-specific information was obtained from one Texas Children’s Advocacy Center on all cases from 2010 to 2013. After the needed deletion, the total number of cases included in the analysis was 309. An outcry was defined as a sexual abuse disclosure. Consistency was measured at both the forensic interview and the sexual assault exam. Logistic regression was used to evaluate whether a correlation existed between disclosure and prosecutorial decisions. Disclosure was statistically significant. Partial disclosure (disclosure at one point in time and denial at another) versus full disclosure (disclosure at two points in time) had a statistically significant odds ratio of 4.801. Implications are discussed, specifically, how the different disciplines involved in child protection should take advantage of the expertise of both forensic interviewers and forensic nurses to inform their decisions.