“Nobody's Perfect”—Partial Disagreement with Herman,Faust, Bridges,and Ahern

This article takes issue with aspects of chapters in Kathryn Kuehnle and Mary Connell's 2009 book, The Evaluation of Child Abuse Allegations: A Comprehensive Guide to Assessment and Testimony.     

Individual Counseling for Sexually Abused Children: A Role for Animals and Storytelling

This article addresses the use of animal assisted therapy in individual counseling for sexually abused children. It focuses on how the animal can help the sexually abused child disclose abuse and express feelings. Storytelling forms a part of the treatment process. The author's clinical experience at Project Against Sexual Abuse of Appalachian Children in Knoxville, Tennessee, forms the basis for the article.     

Forensic, cultural, and systems issues in child sexual abuse cases--part 1: an introduction

This article introduces the first in a two-part special issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. The five articles contained in this issue include a diversity of perspectives on approaches to extended interviews and evaluations of child sexual abuse suspicions, an exploration of the ways culture affects child sexual abuse disclosure and reporting, considerations relevant to the management of a child's mental health needs while forensic process are ongoing, and the use of anatomical dolls in forensic interviews. We call for attention to several practice areas, including (a) prioritizing a child's mental health needs while minimizing disruption of forensic processes, (b) developing best practices and models of child sexual abuse assessment and evaluation when a one-session forensic interview is insufficient, (c) appropriately evaluating child sexual abuse concerns when they occur without a disclosure and/or in children with communication limitations, and (d) the integration of cultural sensitivity into interviews and evaluations.     

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.     

A personal account of developing preventive approaches to the problem of child sexual abuse in the UK

Abstract

This paper is a revised version of a keynote address on Child Sexual Abuse Prevention presented by Carolyn Okell Jones at the first European Congress on Child Abuse and Neglect, Rhodes, Greece 6-10 April 1987, but developed by both authors.     

Book Reviews

Book reviewed in this article: INNOCENCE DESTROYED: A study of Child Sexual Abuse. Jean Renvoize BEYOND BLAME: Child Abuse Tragedies Revisited. Peter Reder, Sylvia Duncan, Moira Gray CARL ROGERS. Brian Thorne WOMEN AND ANGER. Edited by Sandra P. Thomas LIVING WITH IT: A Survivor's Guide to Panic Attacks. Bev Aisbett. Sydney, Angus and Robertson COLLABORATIVE CARE: Interprofessional, Intergency and Interpersonal. Sally Hornby FAMILY VIOLENCE: Everybody's business, somebody's life. Edited by Family Violence Professional Education Taskforce     

Educator Sexual Abuse: Two Case Reports

Sexual abuse by educators has become an increasingly noted type of sexual abuse, especially among adolescents, for two reasons. First, there is a potential for these cases to be silent and prolonged and second, when disclosed, the forensic implications usually include both criminal and/or civil sanctions. For forensic case evaluations, developmental traumatology, or the intersection of the traumatic event(s) at a particular age of the student, is often the evaluating framework. We report on two forensic cases of a female student and a male student to emphasize the dynamics of adolescent sexual victimization, its impact on adolescent development, and evidence-based practice for symptom identification and treatment.     

Reliability of professional judgments in forensic child sexual abuse evaluations: unsettled or unsettling science?

In the absence of photographic or DNA evidence, a credible eyewitness, or perpetrator confession, forensic evaluators in cases of alleged child sexual abuse must rely on psychosocial or "soft" evidence, often requiring substantial professional judgment for case determination. This article offers a three-part rebuttal to Herman's (2009 ) argument that forensic decisions based on psychosocial evidence are fundamentally unreliable and that this conclusion represents settled science. The article also discusses the potentially adverse consequences of Herman's proposed reforms to forensic practice on child protection and prosecution efforts.     

Forensic, cultural, and systems issues in child sexual abuse cases--part 2: research and practitioner issues

This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider in child sexual abuse evaluations, a study of satisfaction levels with multidisciplinary teams in child advocacy centers, and a commentary advocating for the credentialing of forensic interviewers. We call for further empirical examination of media related to child sexual abuse risk, research on appropriate models for extended sexual abuse interviews and evaluations, and optimal practices relevant to each member of multidisciplinary teams in a child advocacy center.     

The composite abuse scale: further development and assessment of reliability and validity of a multidimensional partner abuse measure in clinical settings

Absence of a well-validated comprehensive partner abuse questionnaire has been a major methodological issue in domestic violence research. A new multidimensional measure of partner abuse, the Composite Abuse Scale (CAS), has four dimensions: Severe Combined Abuse, Emotional Abuse, Physical Abuse, and Harassment. A general practice patient sample (N = 1,836) has been used in the development and testing of CAS. Factor analyses in this current study confirmed the four dimensions from a preliminary nurses sample study and resulted in a final scale of 30 items consisting of acts of physical, emotional, and sexual abuse. These four factors exhibited good internal reliability (Cronbach's alpha > 0.85) and the corrected item-total correlations were high (> 0.5). Evidence of criterion and construct validity is presented.     

Forensic Patients and Forensic Mental Health in Victoria: Legal Context,Clinical Pathways,and Practice Challenges

Forensic mental health services in Australia have evolved and developed considerably over the past two decades. To clinicians unfamiliar with them, the contemporary practice environments in which professionals deliver specialised forensic mental health services and the legislation governing offenders with a mental illness can appear extremely complex. This article outlines the legislation applying to individuals found not guilty of a serious offence on the grounds of mental impairment in the State of Victoria, describes the characteristics of the forensic patient population, and delineates the clinical pathway forensic patients typically take, using an illustrative case example. The competencies and attributes required by forensic practitioners are highlighted, along with the clinical challenges they face, including the inherent need to address risk in a service that has become recovery-focused in orientation. A central theme of the discussion is how social workers adapt their practice within these highly regulated settings to effectively meet forensic patients' needs.     

Practical ways psychotherapy can support physical healthcare experiences for male survivors of childhood sexual abuse

Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse (Schachter, Stalker, Teram, Lasiuk, & Danilkewich, 2009), which is intended to help healthcare providers from all disciplines understand the effect of child sexual abuse on some survivors' abilities to access and benefit from health care. This paper discusses what psychotherapists can learn from the healthcare experiences of the male survivors who participated in this project. It also offers practical suggestions for supporting male clients who experience difficulty seeking treatment for physical health concerns.     

Services for Aged Victims:

Little attention has been paid to the nature of service needs of elderly abuse victims, whether these needs are met, and the types of factors which are correlated with the service providers' decision as to what services to provide. This paper provides an analysis of services to elderly abuse victims using data from a study conducted by the Illinois Department on Aging. The report is based on data covering 204 cases which were collected during the calendar year 1986. Abuse types included: Physical Abuse, Confinement, Sexual Abuse, Deprivation, Neglect, Self Neglect, and Financial Exploitation. Case Management was the most frequent type of service the victims received, followed by Homemaking Assistance and Miscellaneous Legal Services. Self Neglect cases received a quite different pattern of services than other types of abuse victims.     

Vicarious trauma:predictors of clinicians' disrupted cognitions about self-esteem and self-intimacy

This study examined vicarious trauma in clinicians who provide sexual abuse treatment (N = 383). A random sample of clinical members from the Association for the Treatment of Sexual Abusers and American Professional Society on the Abuse of Children were surveyed. Vicarious trauma was measured using the Trauma Stress Institute Belief Scale (Pearlman, 2003). Maltreatment was measured using the Childhood Trauma Questionnaire (Bernstein & Fink, 1998). Respondents reported high rates of childhood maltreatment. Simultaneous multiple regression analyses were used to examine relationships between gender, age, maltreatment history, and vicarious trauma. Male gender predicted greater disrupted cognitions about self-esteem and self-intimacy. Clinician age and childhood emotional neglect predicted greater disrupted cognitions about self-intimacy. Implications for education, practice, and research are discussed.     

Sexual Health for the Millennium: An Introduction

ABSTRACT

This special issue of the International Journal of Sexual Health is devoted to the issues of the United Nations Millennium Development Goals and the effort by the World Association for Sexual Health to argue that the promotion of sexual health is an essential strategy for attaining those goals. Recently, the World Association for Sexual Health has published Sexual Health for the Millennium: A Declaration and Technical Document (2008). This special issue of the IJSH contains the background papers which served as a foundation for the development of the declaration and technical document. These articles argue that sexuality is a fundamental aspect of being human, that human development must be premised on the promotion of sexual health and is a basic human right for all citizens. Public policies designed to promote human development must make the promotion of sexual health an essential strategy. This special issue is designed to stimulate more interest in the Sexual Health for the Millennium: A Declaration and Technical Document, encourage further analysis and research which will support the statements in the declaration, provoke more advocacy for sexual health, and, most importantly, to stimulate sound and effective public policies to create a sexually healthier world.     

Recruitment & retention. A successful model in forensic psychiatric nursing

1. The recruitment and retention of forensic psychiatric nurses in this highly competitive environment has been identified as a critical issue. 2. In response to the need to expand services, the development, implementation, and evaluation of an innovative model that has demonstrated success in the recruitment and retention of nurses for this highly specialized area of practice are described. 3. The successful recruitment and retention of forensic psychiatric nurses may be facilitated by developing and implementing strategies that integrate the goals and objectives of the organization with the needs of individual nurses.     

The Atascadero State Hospital experience. Engaging patients in violence prevention.

When it comes to caring for the forensic psychiatric inpatient, there is no "how to" book. In the forensic hospital environment, the commingling of severe and persistent mental illness with criminality poses vexing clinical challenges and complex moral dilemmas not faced in either general psychiatric or correctional environments. While providing evaluation and treatment in our maximum security forensic environment, we continually strive to create and maintain a therapeutic milieu as we fulfill our social mandate to protect the public from the dangerous "criminally insane." Few studies guide us. We do know that within the forensic population there is a spectrum of psychopathology to manage, some of which responds to traditional psychotherapeutic techniques and some of which does not. For example, patients with psychopathic traits may not respond well to traditional treatment methods (Rice, 1997). As forensic psychiatric staff, we sometimes feel as if we are making it up as we go, adapting and blending psychiatric theory with knowledge from penology and criminal justice science to provide a safe environment conducive to growth for patients, the majority of whom may be considered "violence-prone" persons (Toch, 1969). Change is a characteristic of public-sector settings (Smoyak, 1991). Forensic hospitals must continually strive to monitor, refine, and improve their organizational systems as they respond and adapt to constant change. Despite the inherent challenges posed when collaborating with forensic patients, the VAC has achieved some notable successes. Staff and patients have been encouraged to work together to create and maintain a milieu where violence is neither assumed nor condoned. An active collaboration and partnership with our forensic patients has been one component of the hospital's successful violence reduction program. We trust that ASH's successful effort to collaborate with patients on the issue of violence reduction may be of use to other forensic hospitals faced with similar challenges.     

Science or propaganda?an examination of rind, tromovitch and bauserman (1998)

An article, “A Meta-analytic Examination of Assumed Properties of Child Sexual Abuse Using College Samples,” published in the July 1998 edition of the Psychological Bulletin resulted in an unprecedented amount of media attention and became the first scientific article to be formally denounced by the United States House of Representatives. The study's authors analyzed the findings of 59 earlier studies on child sexual abuse (CSA) and concluded that mental health researchers have greatly overstated CSA's harmful potential. They recommended that a willing encounter with positive reactions would no longer be considered to be sexual abuse; instead, it would simply be labeled adult-child sex. The study's conclusions and recommendations spawned a debate in both the popular and scholarly press. A number of commentators suggested that the study is pedophile propaganda masquerading as science. Others claimed that the authors are victims of a moralistic witch-hunt and that scientific freedom is being threatened. After a careful examination of the evidence, it is concluded that Rind et al. can best be described as an advocacy article that inappropriately uses science in an attempt to legitimize its findings.