How Qualitative Research Can Inform Clinical Interventions in Families Recovering From Sibling Sexual Abuse

The impact of sibling sexual abuse (SSA) has been culturally and therapeutically minimised and has received scant research attention. Furthermore, prior research has focused upon the separate experiences of the victim or the offender, or upon seeking family dysfunction explanations. In contrast, this qualitative study attempts to understand the experiences of all family members (victims, offenders, parents and other siblings) when SSA is disclosed. The pathway to recovery for each family member is identified. A systemic analysis of these (often conflicted) pathways of recovery provides some surprising findings and contributes to an understanding of the difficulties facing families in this situation, the constraints on family support and connectedness, validation for the victim and offender accountability.     

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.     

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.     

Implications for Sexual Assault Prevention: College Students as Prosocial Bystanders

Abstract

Prosocial bystander interventions are promising approaches to sexual assault prevention on college campuses. Objective: To assess bystander attitudes among undergraduate students at a northeastern university. Participants: A convenience sample of 188 students from 4 undergraduate classes was surveyed during regularly scheduled class sessions. Methods: Participants completed a short survey on bystander efficacy, readiness to change, and barriers to intervention prior to the start of class. Results: The majority of students were not involved in activities or programs focused on sexual assault prevention. Although students agreed that violence could be prevented, they perceived many barriers to their own participation in intervention. Conclusions: There is a need for gender-targeted prevention programming that introduces the idea of prosocial bystander intervention, with a focus on increasing self-efficacy and lowering barriers.     

Sexual Offending in Adolescence: A Comparison of Sibling Offenders and Nonsibling Offenders across Domains of Risk and Treatment Need

Sibling sexual offending has received limited empirical attention, despite estimates that approximately half of all adolescent-perpetrated sexual offenses involve a sibling victim. The present study addresses this gap by examining male adolescent sibling (n = 100) and nonsibling offenders (n = 66) with regard to maltreatment histories and scores on two adolescent risk/need assessment instruments, the ERASOR and YLS/CMI. Adolescents who sexually abused a sibling, versus a nonsibling, were more likely to have histories of sexual abuse and been exposed to domestic violence and pornography. There were no group differences on ERASOR and YLS/CMI scales. This study adds to the limited discourse on sibling sexual offending and the larger literature on the heterogeneity of adolescents who have sexually offended.     

Evaluation of the RAINN National Sexual Assault Online Hotline

ABSTRACT

This article describes the evaluation of rainn National Sexual Assault Online Hotline, a new model for delivery of rape and sexual assault crisis services through a secure, confidential chat-based online hotline. Outcome data from 623 visitors and 54 volunteers for the first 11 months of the program are presented. The results indicate that the model is viable and useful for approximately 80 percent of visitors, and volunteers are satisfied with the program. Recommendations for program development and further research are presented.     

Counseling Family Members of Addicts/Alcoholics: The Stages of Change Model

This article adapts the stages of change model, a model in which specific interventions of harm reduction are directed toward the client's readiness for treatment, as a guiding framework for counseling family members of alcoholics/addicts. Interventions at each stage of the family's readiness for change, from precontemplation to action, are described.     

The Reporting of Domestic Violence and Sexual Assault by Nonstrangers to the Police

We examine the effects of the gender of the victim and offender and their relationship to each other on whether sexual and physical assaults are reported to the police. We also examine the reasons victims give for not reporting assaults and whether reporting patterns have changed over time. The analyses are based on a sample of 6,291 physical assaults and 1,787 sexual assaults from the National Violence Against Women Survey. The results suggest that victims are just as likely to report domestic assaults as they are to report assaults by other people they know. Male victims are particularly reluctant to report assaults by their intimate partners, whereas third parties are particularly unlikely to report assaults by partners of either gender. Sexual assaults, particularly those that involve acquaintances, are less likely to be reported. These patterns have not changed since the 1960s.     

The Seven Pillars of Quality Care in a Statewide Pediatric Sexual Assault Nurse Examiner Program

This article describes a systematic approach used by a statewide pediatric sexual assault nurse examiner program to ensure the quality of forensic medical examinations it provides in child sexual abuse investigations. Seven strategies for enhancing quality are described: (a) hiring experienced professionals, (b) effective training, (c) comprehensive protocols, (d) ample support for pediatric sexual assault nurses, (e) management oversight, (f) a clinical coordinator to provide ongoing training and technical assistance, and (g) a quality assurance process in which expert child abuse pediatricians review each statewide pediatric sexual assault nurse examination. To show the evolution of quality care over time, the program's experience from 2004 to 2010 is reviewed, and quality assurance data are analyzed.     

Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

Abstract

Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month follow-up surveys assessing sexual attitudes and knowledge as well as experiences with assault. Results: The results reinforce previous findings that Elemental is effective in reducing sexual assault risk. Program effects were both direct, in that participation was associated with lower risk of assault, and mediated, in that participation impacted attitudes and beliefs that are empirically linked to risk of later assault. Conclusions: By combining both primary prevention and risk reduction approaches, Elemental is not only effective at reducing incidences of assault, it is also consistent with a number of recent recommendations for directions in sexual assault prevention programming.     

Constructing Victims: The Erasure of Women's Resistance to Sexual Assault

How do the news media portray women's resistance to sexual assault? We analyze articles from a systematic sample of 16 U.S. newspapers across 1 full calendar year to assess whether and how newspapers describe women's resistance. We find that in most cases, newspaper reports reinforce the belief that women are incapable of effectively defending themselves. Most articles fail to mention women's resistance or do so only to note its failure; the longer the article, the more likely it is to follow these patterns. Headlines exaggerate these patterns, presenting virtually no evidence that the articles that follow, or that assaults themselves, contain any female resistance or agency. In only a very small minority of cases are women described as strong, competent actors with the ability to defend themselves against violence. We conclude with a discussion of the potential individual and societal consequences of these patterns.     

Sexual Assault on College Hookups: The Role of Alcohol and Acquaintances

This article takes a new approach to the study of college sexual assault by conducting an analysis of female students’ most recent “hookup.” By isolating a particular hookup event and examining the features of that event, I am able to examine predictors of sexual assault during hookups. My analysis focuses on the implications of alcohol consumption and knowing a male partner before a hookup, while controlling for multiple individual, school, and situational characteristics, using data from the Online College Social Life Survey collected 2005–2011. In my sample, 2.4% of women experienced sexual assault during their most recent hookup. Results show women do not experience an increased risk of physically forced intercourse until they have consumed nine or more drinks. In addition, women were more likely to report sexual assault during a hookup with a man they did not know well. Together, these findings suggest that men are more likely to assault women who are drunk, possibly because the double standard has made them respect such women less, or because they target women who are likely unable to resist or recall what happened. It also appears that the “in‐network stranger” may be the individual most dangerous to women in college hookups.     

Mediators of Sexual Revictimization Risk in Adult Sexual Assault Victims

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.     

There is No Place Like Home: The Body as the Scene of the Crime in Sexual Assault Intervention

ABSTRACT

“The body is the scene of the crime,” is an oft-repeated phrase among nurses conducting sexual assault forensic examinations. This instruction reminds nurses that the object under scrutiny, the sexually violated body, is the location and source of establishing legal evidence. The nurses' interest lies in recovering evidentiary materials towards deriving a future juridical truth and providing a means for remedy or restitution. The constitution of truth obscures how the subject comes to be at home and dwell in a world where rape occurs. This article argues that regarding the body as a crime scene is more than a rhetorical or pedagogical move made by forensic practitioners. Rather, forensic examination is constituted through rigorous and meticulous techniques that scrutinize the body of the sexually violated subject in such a way that the harming and healing capacities of the domestic are disarticulated from one another. What is at stake is the state's reliance on a notion of the domestic as a sphere to which one might return and heal, even in instances where the domestic itself is the source or site of injury, such as incest and domestic violence.     

Race Differences in Family Experience and Early Sexual Initiation: Dynamic Models of Family Structure and Family Change

We examine the effects of family structure on age at first sexual intercourse before marriage for a recent cohort of women. Previous research on the linkage between family structure and sexual initiation has employed relatively crude measures of family structure—typically a snapshot of the respondent's family structure at age 14. We use retrospective parent histories from the 1979–1987 National Longitudinal Survey of Youth to construct dynamic measures of family structure, using information on the number and types of parents in the respondent's household between birth and age 18. We use these measures in proportional hazard models to test the effects of prolonged exposure to a single‐mother family, prolonged absence of a biological father, parental presence during adolescence, and family turbulence. For White women, age‐specific rates of first sexual intercourse are significantly and positively associated with the number of family transitions; for Black women, age‐specific rates are significantly and positively associated with having resided in a mother‐only or father‐only family during adolescence. Net of other effects of family structure, we find no significant effects for White or Black women of being born out of wedlock, prolonged exposure to a single‐mother family, or prolonged absence of a biological father. Our results for White women are consistent with a turbulence hypothesis, whereas for Black women our results suggest the importance of family structure during adolescence. For neither White nor Black women are our results consistent with hypotheses positing earlier initiation of sexual activity for women with prolonged exposure to a single‐mother or father‐absent family.     

Stifled Voices: Barriers to Help-Seeking Behavior for South African Childhood Sexual Assault Survivors

In South Africa, females under the age of 18 comprise approximately 40% of the rapes and other forms of sexual assault that occur. However, South African girls face multiple barriers to seeking help in the aftermath of sexual assault. This literature review provides an overview of childhood sexual assault in South African girls and addresses barriers to help-seeking behaviors. Risk factors as well as relevant sociocultural, economic, structural, and psychological perceptions regarding childhood sexual assault among South African girls are also discussed. Finally, clinical implications, culturally relevant psychotherapeutic techniques, and suggestions for future research are provided in an effort to reduce the negative mental health consequences for the victims.     

Case Work in Social Work: Exploring the use of Reflective Letters in the Intensive Family Support Services

This paper begins by reviewing the current policy context of ‘evidence based interventions’, a term littered in social work literature and more recently working with complex families in Wales. This study demonstrates the application of practice of a range of workers located in the Integrated Family Support Services (IFSS) in Wales in the context of reflective letters utilising motivational interviewing (MI) techniques. As part of the MI method, which is used as a model for practice in the IFSS, the consultant social worker, alongside other practitioners, uses a range of tools including the use of reflective letters and narrative principles. These letters are evidence themselves of the work and therapeutic conversations that happen during sessions within the family home, and with various family members. This paper draws on 14 samples of reflective letters from current practice in Wales and explores and considers their application to practice and areas for further development.     

Ten Research Questions for Family Therapy

A growing evidence‐base shows that family therapy works, but many gaps in our knowledge remain about the conditions under which family therapy is effective and how it works. In this paper, ten critical research questions about family therapy that need to be addressed are considered. In short these are:

• 1 Is family therapy as effective in community settings as it is in specialist clinics?
• 2 For what problems is family therapy cost‐effective?
• 3 Does family therapy work for under‐researched problems and populations?
• 4 Do social‐constructionist and narrative approaches to family therapy work?
• 5 Can family therapy protocols be enhanced for non‐responders?
• 6 Can family therapy be combined with other psychotherapies to effectively treat specific problems?
• 7 Can family therapy be combined with pharmacotherapy to effectively treat specific problems?
• 8 What specific factors contribute to the effectiveness of family therapy with particular problems?
• 9 What common factors contribute to the effectiveness of family therapy?
• 10 What therapist and client factors contribute to the effectiveness of family therapy?

     

Teaching and Learning Theory For Family Therapy Practice: On The Art and Craft of Balancing

As with all practice knowledges, family therapy theory sits in a complicated relationship to practice. This paper offers a set of reflections exploring challenges of teaching and learning theory for, and about, practice in family therapy. The importance of teaching particular frameworks of practice sits in tension and balance with the importance of the common factors of therapeutic change, and the inseparability of the use of self and the use of particular practice knowledge. Passion and commitment to particular ways of working is held in balance with the need for flexibility and the freedom to think independently. Discipline and focus is balanced with creativity and the room for integration. A number of balancing practices are identified in the art and craft of teaching, and the contextual issue of power and vulnerability in the teaching and learning relationship is acknowledged. Finally, the three ‘Rs’ in teaching and learning family therapy practice theory are drawn out – reflection, the recursiveness of theory and practice, and the reflexivity of self in relation to context and knowledge.     

Exploring Mental Health Adjustment of Children Post Sexual Assault in South Africa

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault center. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, we observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children.