Sense of coherence in women with a history of childhood sexual abuse

Women with a history of childhood sexual abuse experience a range of difficulties. The aim of the present study is to examine the personal resources of women with such a history measured using the SOC scale. The relationships of SOC to other factors were analysed. Eighty-one women who participated in self-help groups were questioned using the 29-item version of the SOC scale. The SOC mean score for the whole group was 104.1 (range 58–187). The women who had a more than ten-year duration of sexual abuse had a low SOC score (M = 96.8) but those who did not remember the number of years of duration had an even lower score (M = 94.4). In a first step of multiple regression analysis of childhood sexual abuse characteristics and SOC total score, only duration of sexual abuse was entered and accounted for 10.3 per cent of the variance. In a second step of multiple regression analysis, relationship to fellow workers was a significant predictor of SOC and contributed to 31.7 per cent of the variance.     

Preliminary data on abuse during childhood among female university students

This study investigated the childhood experiences of physical and sexual abuse in relation to the risk of adult depression among female university students. The objectives of the study were to determine the prevalence of abusive experiences in childhood, to examine if childhood physical and sexual abuse, parental antipathy and neglect correlated to depression, and to determine the risk factors of depression in this population. A translated childhood experience of care and abuse questionnaire (CECA-Q) was randomly distributed to the students. The results showed that the reliability of the CECA-Q was good and stable. The prevalent rate of childhood physical abuse in this population was 19% and childhood sexual abuse was 5%. Childhood physical abuse by the mother was a significant risk factor in contributing to depression. The study provides evidence of a correlation between childhood abuse and depression among female university students.     

Children's narratives of sexual abuse

Children rarely disclose sexual abuse. Hence, studies of children's abuse experiences are relatively rare. This paper reports on a qualitative analysis of 2986 cases of self‐disclosure of sexual abuse from children, aged 5–18 years, who contacted ChildLine Scotland, a free, confidential telephone counselling service. Children discussed their feelings regarding the abuse, the impact of abuse on their health and well‐being, sources of support, disclosure, coping strategies, the context in which abuse occurs and the various ways in which they were groomed or their compliance in abuse was gained. Children's narratives contained detailed contextual information on their experiences of sexual abuse, perpetrators of sexual abuse and the circumstances in which sexual abuse occurs. The way in which children communicated about sexual abuse was found to differ quite considerably, and the terminology they employed was often markedly different from adult constructs. Nonetheless, children of all ages were able to describe their experiences and their feelings around the abuse in considerable detail. This study provides a rare insight into children's accounts of sexual abuse. The findings illustrate the profound impact that sexual abuse has on the lives of children and their understandings of the circumstances in which abuse occurs.     

Needs assessment: an Internet information system for Taiwan's professionals working with adult survivors of childhood sexual abuse

The problem of childhood sexual abuse (CSA) continues as a serious public health issue in Taiwan. However, the current service delivery systems in Taiwan are fragmented and fraught with a variety of problems, similar to those reported in Western society. Because of the sensitive nature of CSA, the development of an internet information system may be helpful in treatment efforts. The Delphi method was used to collect data from 15 professionals in the field of CSA in order to assess the need for such an information system. The needed resources, limitations, and implications of the study are discussed.     

Best practice guidelines for health service professionals who receive initial disclosures of sibling sexual abuse

Sibling sexual abuse is one of the more common forms of child abuse and involves a number of unique complexities. A gap in the literature exists with regards to the appropriate response to an initial disclosure of sibling sexual abuse and the values underlying such a response. This article employs a power and control analysis to consider the definition, prevalence and outcome of such abuse and presents best practice guidelines for health care professionals. The guidelines aim to promote ethical and respectful responses to disclosures of sibling sexual abuse. They reflect an explicit value stance, detailing appropriate responses to disclosure including interagency collaboration, parental notification and consideration of the special status of the abuser as a young person.     

Evaluation of child sexual abuse - what should be evaluated?

An analysis of behavioural changes, mental symptoms and personal characteristics may contribute significantly to the evaluation of child sexual abuse. Examples from children of different ages are presented to illustrate how such information may be used in the evaluation process. Not rarely the psychological investigation of the abuse allegations is regarded as almost synonymous with an analysis of the child and what the child has communicated. In fact, there are many other important - but often neglected - sources of information than those related to the child as an individual. Different kinds of information concerning the suspects are presented as illustrations of this thesis. A hermeneutic approach is advocated for the evaluation. This means that the main issue is understanding the unique rather than knowledge of what is most common.     

Children's and carers' perspectives of a therapeutic intervention for children affected by sexual abuse

This paper presents the findings of a qualitative study with children affected by sexual abuse who had recently completed a therapeutic intervention (N = 12) and their carers (N = 17). Four themes emerged from the thematic analysis that influenced participants' satisfaction with the service: the attribution of the child's recovery to the therapeutic support received; the therapeutic relationship between the child and practitioner; children's recollection of important aspects of the intervention and the relationship between the carer and the child's practitioner. The findings indicate that the process elements of therapeutic support, including the development of strong relationships and allowing children choice and control, are as important as the content.     

Helping families when child sexual abuse is suspected but not proven

This paper reports from a project investigating reactions within families when intra‐familial child sexual abuse was suspected, and family members’ responses to a therapeutic approach. Data were obtained from therapeutic sessions and follow‐up interviews with mothers, children and alleged perpetrators. Before treatment the mothers felt uncertain as to how to interpret the children’s unclear signs. The children had severe symptoms, but had seldom disclosed abuse. The alleged perpetrators were often not informed about the suspicions. The families were in a state of crisis and shock, and communication within the family was characterized by uncertainty about what to talk about and whether the suspicions should be shared. In most cases after treatment the conflicts had been reduced, the children had few symptoms, supervised contact had been established, and the clients were satisfied with the treatment. One conclusion is that therapeutic sessions, where family members share information about concerns and take part in the decisions of how to protect children, seem relevant and helpful to the clients in unclear abuse cases.     

User-centred responses to child sexual abuse: the way forward?

Two parallel surveys were carried out based in the north-east of England and Cumbria: one ascertaining statutory social work services provided for child and adult survivors of sexual abuse, the other drawing upon the perceptions of adult survivors of child sexual abuse about existing and desirable forms of provision for adults and children. The surveys indicate the need for greater genuine partnership between service users and statutory agencies in the field of child sexual abuse, similar to that which is being pioneered in the field of adult care and disability. A community-orientated response to sexual abuse, centred on service-users, is required if one of the largest social problems facing us today is to be effectively challenged.     

Non‐abusing mothers' support needs after child sexual abuse disclosure: A narrative review

The role of maternal support has been perceived as vital throughout the recovery process of sexually abused children. However, it is important to look at the concept “support” from the perspective of non‐abusing mothers' personal needs. This narrative review of the literature aimed to find out how non‐abusing mothers' need for support in their responses to disclosure of child sexual abuse has been recognized. A comprehensive search on Jyväskylä University Library interface yielded 12 academic articles based on empirical research. These articles were selected from those considered to have sufficiently investigated support for non‐abusing mothers and included a mixture of qualitative, quantitative, and mixed‐method research. The data consisted of peer‐reviewed online articles published in English between 2000 and 2017. Four themes emerged from the thematic analysis: improving the quality of the whole social support network for non‐abusing mothers; being blamed, maternal guilt, and shame; anger; and coping strategies. The findings show that the support needs of non‐abusing mothers are usually explained based on their interaction with sexually abused children. However, it is necessary to listen to women's needs independently of their mothering role. If these mothers are better understood, not only they, but also their children, could be empowered.     

Applying narrative analysis to the process of confirming or disregarding cases of suspected sexual abuse

This article analyses discourse about sexual abuse at a detention home for young women. At the centre of attention is staff members’ struggle with the process of confirming or disregarding cases of alleged sexual abuse. The determining factor for establishing an act as sexual abuse was whether or not the act involved a person who was defined as a victim. A core issue in the process was an evaluation of the credibility of the alleged abused girl and the degree of consent. The unintended result was that many of the girls’ narratives were never confirmed. The article argues that there is no objective ‘given’ regarding the definition of sexual abuse. To be involved in the process of understanding and establishing an act as sexual abuse means being involved in a process of social definition. To be able to handle such involvement constitutes a fundamental professional issue in social work. Adopting a narrative approach to the process of confirming or disregarding cases of suspected sexual abuse shifts the focus from developing categories of social problems and work on the basis of them to developing ways of listening to young people and allowing their narratives to provide a point of departure.     

Pictures and silences: memories of sexual abuse of disabled people

The article de–individualises the debate about sexual abuse of disabled people, especially women, by showing that both the sexual and asexual identity of impaired persons are invariably fashioned within the institutional arrangement of domination and subjugation. It shows that if disabled persons are seen as asexual or if they are sexualised, they cannot escape sexual violence, which is not an aberration, but is intrinsic to the social construction of disability. The article includes personal testimonies of women with different disabilities from Slovenia, who were abused either at home or in public care and shows some responses of the professionals and caregivers who minimise the importance of abuse. It claims that ignoring the memories of sexual abuse is part of a subtle and unintentional discrimination, which reflects a continuity of prejudices and hatred toward disabled children and adults in the private realm as well as in public care. People from ethnic minorities, such as Roma, are still today more often diagnosed as mentally disabled, which shows that the disability diagnosis has to be seen as part of cultural responses towards an economically and socially marginalised group. The author uses different perspectives: historical, social work theories, cultural studies and feminist analysis.     

Responding to child sexual abuse: an evaluation of social work by children and their carers

This paper presents the views and perceptions of 35 children and their current carers regarding the social work response to child sexual abuse. Interviews with the children and carers, including foster carers and residential carers, were carried out 2–4 years following disclosure, thus the nature of social work support in the longer term, as well as the initial response, is assessed and described. Three evaluations of social work support are presented: the child-ren's evaluations of social workers known since disclosure, and two evaluations from the carers, one focusing on the child's needs, and one focusing on their own as carers. All three evaluations perceived the majority of social workers as having helped. Aspects of social work considered essential included providing emotional support and reassurance, providing information and explanation and arrang-ing and coordinating services, including counselling or therapy.
  Carers of children who were abused by someone outside the family were less likely to receive social work support. The frustra-tion and disappointment expressed by some of these carers reaffirms the importance of assessing needs even when the child is considered protected from further abuse. The findings of this study support the need to refocus responses to abused children and their families.     

Parenting conditions in the midst of suspicion of child sexual abuse (CSA)

This paper presents the findings of an exploratory study on parenting in the midst of suspicion of child sexual abuse (CSA). Data were drawn from in‐depth interviews with 19 parents. Five of these had been accused of CSA. Study methods followed guidelines of grounded theory approaches. Specific parenting conditions during CSA suspicion were identified. Six analytic categories were developed: uncertainty concerning abuse, dilemmas on protection, changes in parent–child relationships, changes in the natural support network, dependency upon professional competence and severe emotional strain. The results are suggested as a tool for identifying themes in order to support and strengthen parenting in ensuring the safety and well‐being of children in these kinds of situations. The current paper contributes to the field by exploring the perspectives of both suspected and non‐suspected parents.     

Women,trauma and substance abuse: Understanding the experiences of female survivors of childhood abuse in alcohol and drug treatment

Despite the available evidence suggesting gender should be considered in the provision of alcohol and/or drug (AOD) treatment, programmes are frequently offered in an apparent ‘gender vacuum’. This article argues that the generalist ‘one size fits all’ approach of many AOD services is not gender neutral but should be understood as implicitly gendered in that it neglects the specificity of women's needs in relation to abuse, mental illness and parenting. The discussion presented in this article is based on a qualitative study of the experiences of adult women with histories of childhood sexual abuse and/or domestic violence in AOD treatment. By examining the ways in which AOD treatments effectively ignore or minimise gender, this article uncovers intervention practices that efface the complexities underpinning AOD use among women and suggests ways in which alternative models of service delivery can create more validating and supportive environments. Key Practitioner Message: ● Some of the common assumptions underpinning alcohol and drug treatment do not adequately acknowledge the specific needs of female clients and so gender‐neutral service provision can be disenabling for women; ● Punitive service cultures or behaviour change strategies have a differential impact on female clients, many of whom have prior and ongoing experiences of abuse and violence; ● Service models that acknowledge the complex responsibilities and relational histories of female clients are more likely to engender a positive response and provide the opportunity to address the multiple and complex needs that can go unmet in non‐specialist services.     

Parental experiences in cases of child sexual abuse: a qualitative study

This paper describes the themes which emerged from in-depth interviews with parents of a small number of Australian children who were believed to have been sexually abused. The parents' experiences in the wake of the abuse, including their involvement with three services - a hospital counselling service, the statutory child protection service, and the police - were explored in home interviews conducted 3 months following termination of the case by these services. The themes include: issues related to trust and authority in the casework relationship; expectations of counselling; contamination of normal sexuality in the family; the perception of the sexually abused child as'damaged'; and relationships within their family and social network. Some of the implications for practice are discussed.     

Living on an island: consequences of childhood abuse, attachment disruption and adversity in later life

This paper reports on a study which sought to obtain greater knowledge and understanding of the life circumstances of a group of people who had experienced adversity and abuse in childhood. A qualitative research strategy involving in-depth interviews with individuals was used to help achieve the study's aim. The study found that interviewees detailed multiple risks to their development during childhood and adolescence, including experiences of child abuse, being placed in care and major grief and loss experiences. Most had left home in their mid-teenage years and had little or no contact with their families of origin. Interviewees had very limited social networks and described difficulties in making and keeping friends. Many reported unstable and often violent personal relationships. As suggested by attachment theory, this study supports the notion of developmental continuities from adverse childhood experiences into later life, particularly in relation to personal and social relationships. Recommendations for a number of suitable methods of intervention and support are outlined.     

Professionals' attitudes about victims of child sexual abuse: implications for collaborative child protection teams

In responding to victims of child sexual abuse, considerable attention has been given to multidisciplinary collaborative response teams. Recent evidence, however, suggests that team members may be divided by differences in attitudes towards victims and offenders and about the causes and consequences of abuse. This paper draws on a larger study of the various professionals who make up one child abuse response system in Newfoundland, Canada. In particular, the paper focuses on social workers, teachers and the police, and their views about the characteristics and credibility of sexual abuse victims, and the extent to which they attribute to the victim some responsibility for the abuse. Data for the study were collected in two stages: key informant interviews; and a survey of social workers, teachers and police. The analysis includes an interpretation of the role of gender, professional group membership and experience with cases. The most striking finding is the extent to which the child's age and behaviour appears to influence differentially attitudes about the victims' credibility. These differences complicate multidisciplinary collaborative initiatives since it would appear that those with the least real case experience, and the least knowledge about the relationship between abuse and behaviour, are the ones most likely to be the first point of contact for reports or disclosures.     

Bridging the gap: feminist theory and practice reality in work with the perpetrators of child sexual abuse

Child sexual abuse has been a focus of concern for feminist writers for over a decade, and social work and probation practitioners are spending an increasing amount of time undertaking intervention with men who sexually abuse children. This paper uses a review of feminist literature which identifies three contested areas in the feminist discussion: theory, power and the fixity of gender, and discusses whether these debates are reflected in any way in the interventions being undertaken with men who sexually abuse children. The conclusion reached is of a distance between theory which draws on a radical patriarchal analysis of child sexual abuse and the practice of those who attempt to work with the perpetrators of such abuse. Although some workers frame their intervention in terms of a patriarchal understanding of society and of the nature of power within this – to this extent following a radical feminist approach – there is a sense in which practitioners' use of feminist theory is only partial. Thus feminist theory is often presented as unitary and there is a sense in which practitioners who say they are espousing feminism are not in touch with the subtleties of feminist analysis revealed in the literature review. In addition, the logic of the radical feminist perspective is not followed through in practice as there is evidence of a sensitivity to difference which may be aligning practitioners with a post-modern/post-structural interpretation of men's sexual violence towards children.     

Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n = 387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing. When mean attitude scores were correlated with mean definition scores, Pearson's r returned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors of R² change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse. Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.