Efficacy of a group therapy for sexually abused adolescent girls

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 significant 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, relationship 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.     

Comparison of open versus closed group interventions for sexually abused adolescent girls

A first aim of this study is to evaluate the efficacy of an open group therapy for sexually abused teenagers using a quasi-experimental pretest/posttest treatment design. A second aim was to explore whether differential gains were linked to an open versus a closed group format. Results indicate that sexually abused girls involved in an open group therapy showed significant gains relative to teenagers of the control group girls for the majority of the variables considered. Analyses contrasting the two formats of group therapy fail to identify statistical differences suggesting that both open and closed group formats are likely to be associated with the same significant gains for sexually abused teenagers.     

Signs of resilience in sexually abused adolescent girls in the foster care system

In a sample of 99 sexually abused adolescent girls in the foster care system (64% in congregate living situations and 36% in family/foster care homes), nearly half were psychologically functioning well despite having experienced moderate-to-severe emotional, physical, and sexual abuse. It was hypothesized that these girls with resilient trajectories would differ from the currently symptomatic girls on several protective factors: education, future orientation, family support, peer influence, and religion. The results revealed that the girls with resilient trajectories were significantly more certain of their educational plans and optimistic about their future and had more positive peer influences.     

Ethnic differences in symptom presentation of sexually abused girls

Although researchers have begun to examine the issue of ethnic and cultural factors in childhood sexual abuse (CSA), relatively little has been done to look at possible ethnic and cultural differences in psychological symptoms related to CSA. This study investigated the relationship between ethnicity and symptom presentation among Hispanic, African American, and Caucasian sexually abused girls. The study examined the relationship between ethnicity and depression, ethnicity and post-trauma intrusive symptoms, and ethnicity and post-trauma avoidance symptoms. Results indicated that African American girls had significantly higher levels of post-trauma avoidance symptoms than Hispanic girls, but not Caucasian girls. No significant differences were found between ethnic groups for depression or intrusive symptoms.     

Betrayal and repetition: Understanding aggression in sexually abused girls

Betrayal by a significant object is seen as primary in causing behavioral and emotional disturbances in incest victims, leading to a pervasive identification with the aggressor and disturbances in object relations development. Identification with the aggressor is understood not as a uniform defense mobilized against a specific affect but as a complex compromise formation which defends against anxiety, while also providing libidinal, aggressive and superego gratifications. Far from simply attempting to overcome the past, identifications thus preserve affects that have become pleasurable and self-defining. Two case studies of adolescent girls illustrate how treatment can help victims recognize and begin to forego the sadomasochistic pleasure derived from these identifications, a relinquishment necessary for true mastery.     

Reliability of self-reported contraceptive use and sexual behaviors among adolescent girls

This study examines two issues relevant to adolescents' self-reported sexual and contraceptive use behaviors: reliability of partner-referent reports versus 3 and 6 month reports, and test-retest reliability of reports completed over a 2 week period. Data are from 196 13 to 18 year old girls recruited into this study while they south reproductive care from health clinics in a metropolitan area. All participants reported having had sexual intercourse during the past 6 months. Twice over a 2 week interval, participants completed the same paper and pencil surveys. The survey presented questions about sexual behavior and contraceptive use using 3 sequential frames of reference: within the past 6 months, within the past 3 months, and by specific sexual partners in the past 6 months. Findings demonstrate that adolescent girls can reliably report sexual behavior and contraceptive use over a 6 month interval. Study findings have implications for future research utilizing adolescents' self-reported sexual and contraceptive use behaviors.     

The fate of the sexually abused child

This article emphasizes the importance of understanding the specific meaning of sexual abuse to the particular child in his/her particular developmental stage. A critique of the research is presented, along with discussion of the psychodynamic impact of sexual abuse on the developing ego of the child. The primary means of adaptation following the trauma are (1) identification with the aggressor and (2) the repetition compulsion. It is also suggested that Freud's seduction theory can coexist with his later fantasy theory. Two case vignettes are presented to highlight the theoretical discussion.     

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.     

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.     

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.     

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.     

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.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.     

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.