An Evaluation of a Group Treatment for Sexually Abused Young Children

ABSTRACT

The present study measured outcomes of a group treatment for five-to eight-year-old sexually abused children. Although research completed in the last 10 years has produced some outcome studies on the effectiveness of group treatment for this population, no previous research has measured the effectiveness of psychoeducational interventions, such as the teaching of sexual information and abuse prevention strategies which are often included in this type of treatment. Also, the effects of different lengths of treatment have not been studied. The results of the current study found that children improved significantly from pre-treatment to mid-treatment on measures of problematic behavior, sexual information and abuse prevention. The children also made significant improvements from mid-treatment to post-treatment and from pre-treatment to post-treatment on all of the outcome measures with the exception of mid-treatment to post-treatment changes on the maternal acceptance self-esteem subscale. These results suggest that young children do benefit from a sexual abuse group treatment and that a longer treatment may be more beneficial.     

Relationships between maternal adult attachment security, child perceptions of maternal support, and maternal perceptions of child responses to sexual abuse

This study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse among African-American child sexual abuse victims aged 4 to 12 (n=96) and a comparison group of non-abused subjects (n=100). Mothers with insecure attachment styles reported significantly higher rates of internalizing behaviors in their sexually abused children than did securely attached mothers. Among mothers of non-abused children, those with insecure adult attachment styles reported significantly higher rates of externalizing behaviors shown by their children in comparison with mothers with a secure adult attachment style. Mothers with insecure adult attachment styles also reported higher rates of overall behavior problems in their non-abused children that approached statistical significance. Sexually abused children's perceptions of maternal support were not related to maternal attachment style nor to child functioning. Contrary to our prediction, mothers of sexually abused children did not show lower rates of secure attachments when compared to mothers of non-sexually abused children. Our findings indicate that fostering parent- child attachment is important in order to decrease the risk for behavior problems and symptomatology in sexually abused children.     

Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended. The model proved effective for treating young female victims of sexual abuse.     

Longitudinal Study of the Psychological Effects of Sexual Abuse in African American Girls in Foster Care and Those Who Remain Home

This study longitudinally examined the effects of foster care placement versus remaining at home upon the psychological functioning of 64 African-American, sexually abused girls aged 5-16 years. The children were intitially evlauted with a multi-method assessment protocal within six months following report of the abuse and then reevaluated approximately one year later. The findings indicate that the group as a whole showed a decline in affective distress and depression. However, the children continued to show disturbed perceptions of relationships and high levels of stress relative to their adaptive coping skills. The caregivers continued to rate the children as showing many behavioral problems, low social competence, considerable sexual abuse-related anxiety and sexual acting-out behavior. Overall, there were no significant differences in the psychological functioning of the girls who remained at home and those who were placed in foster care. In supplementary, cross-sectional analyses involving 24 additional subjects, several maternal variables were found to be related to the child's adaptation.     

Interpretations of Facial Expressions of Emotion by Sexually Abused and Non-Abused Girls

Physical abuse history has been demonstrated to have an effect upon accuracy of interpretation of facial expressions, but he effects of sexual abuse have not been explored. Thus, the accuracy of interpretation and the role of different facial components in the interpretation of facial expressions were studied in sexually abused and non-abused girls. Twenty-nine sexually abused and 29 non-abused females, ranging in age from 5 to 9 years, chose schematic faces which best represented various emotional scenarios. Accuracy of interpretation of facial expression differed between sexually abused and non-abused girls only when emotion portrayed was considered. A history of sexual abuse alone had no effect upon overall accuracy, but did influence performance on specific emotions, particularly at certain ages. In this investigation, specific facial component had no effect on integretation of facial expressions. Rather than exhibiting patterns o fp overall arrested development, these sexually abused girls seemed to focus upon selected emotions when interpreting facial expressions. Findings regarding lhis selectivity of emotions or heightened awareness of particular emolions (e.g., anger) may be quite useful in understanding the effects of sexual abuse and in the advancement of treatment for sexual abuse victims.     

Sexual at-risk behaviors of sexually abused adolescent girls

The present study investigated sexual at-risk behaviors of sexually abused adolescent girls. Variables of interest were presence of consensual sexual activity, age at first consensual intercourse, number of sexual partners, condom use, and pregnancies. Participants were 125 sexually abused adolescent girls aged 12 to 17 years. Results showed that severity of sexual abuse (e.g., penetration, multiple perpetrators, physical coercion, multiple incidents of abuse) was related to a greater number of sexual at-risk behaviors. For instance, adolescents with a history of sexual abuse involving penetration were 13 times as likely to have been pregnant. Although family characteristics were significantly associated with being sexually active, their effect proved non-significant in the final hierarchical regression. Regression analyses clearly showed that the likelihood of engaging in sexual at-risk behaviors increased as a function of the number of severity factors.     

Sexual abuse and group therapy

This article described the formation of a structured, open-ended, time-limited, repeatable group for sexually abused girls. The sexually abused pre-adolescent and young adolescent must address developmental tasks while attempting to cope with tremendous guilt, shame, and loss of self-esteem. The value of group therapy as a support to sexually abused children was explored and a format was devised to help them deal with their issues. Discussion questions and topics designated for each session helped meet their specific needs. The group members evaluated the group as being helpful overall. In conclusion, the expansion of psychotherapeutic services to sexually abused children through a structured group format has been proposed. If others are encouraged to engage in such work, then the purpose of this article has been achieved.     

The relationship of sexual abuse to symptom levels in emotionally disturbed girls

This research study examined symptom levels and sexual abuse status of emotionally disturbed girls in residential treatment. Sexually abused girls had poorer self esteem, higher levels of anxiety, and a trend toward more depression than the nonabused girls on self-report measures. Measures completed by the residents' therapists also found sexually abused girls as being more symptomatic in a number of areas.This research was made possible by a grant awarded to both authors from the Faculty Research and Innovation Fund of the University of Southern California and a Rhoda G. Sarnat Junior Faculty Endowment to Dr. Mennen.     

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.     

The frequency of sexual abuse and depression in a sample of street children of one of deprived districts of Tehran

The purpose of this study was to determine the frequency of sexual abuse and depression among street children who live in a deprived district of Tehran. The researchers used the K-SADS questionnaire and a clinical interview were used to evaluate depression and sexual abuse in 87 street children in Tehran. Eighteen (20.9%) of the children had been sexually abused. Depressed children were 3.2 times more likely to be sexually abused than non-depressed children. Furthermore, 26 girls (86.7%) and 27 boys (48.2%) suffered from depression. The frequency of depression demonstrated a significant association with the father's or breadwinner's history of imprisonment or unemployment. Interventional programs providing education and support should be implemented for street children.     

Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child Advocacy Center participated in the study. Results indicate that children in the groups that included therapy dogs showed significant decreases in trauma symptoms including anxiety, depression, anger, post-traumatic stress disorder, dissociation, and sexual concerns. In addition, results show that children who participated in the group with therapeutic stories showed significantly more change than the other groups. Implications and suggestions for further research are discussed.     

An individual treatment programme for sexually abused adult males: description and preliminary findings

Growing recognition of male sexual abuse and its potentially debilitating effects has underscored the need to develop effective treatment interventions for this population. The present study describes an individual treatment programme that was developed for adult males who have experienced childhood sexual abuse. The treatment programme focused on three areas related to sexual abuse, specifically feelings of self‐blame, anger and anxiety. The study also presents preliminary findings on treatment effects, using self‐report measures that five participants completed prior to treatment and at various assessments following treatment termination. Overall findings indicated improvements in behavioural self‐blame, anger, state anxiety and trait anxiety. Treatment did not appear to have an effect on characterological self‐blame over the long term. The study's findings are limited by the reliance on self‐report data and the absence of a comparison group. As such, our findings should be viewed as an initial contribution to the currently limited empirical data on treatment effects for sexually abused adult males. Copyright © 2005 John Wiley & Sons, Ltd.     

Group therapy with sexually abused boys: Notes toward managing behavior

This article examines the gender-specific defense mechanisms of sexually abused boys as they emerge in group therapy, using Finkelhor's model of traumagenic dynamics. Concrete interventions address the acting out behavious that are typical for this population, connecting the acting out behaviors to the boys' common background of sexual abuse. Without these concrete interventions to address the unsafe, aggressive behaviours of sexually abused boys, their problems and experiences cannot be shared, nor can the group therapist address the issues outlined in a curriculum for group therapy for sexually abused children.     

What do young children know about sex? Research on the sexual knowledge of children between the ages of 2 and 6 years

We investigated the sexual knowledge of 63 Dutch children in the age range 2–6 years. Boys and girls were equally represented in the sample. The children had an average, or above‐average IQ and none of them had any experience of sexual abuse. It was found that young children have a very limited knowledge of sexuality. They only possess some basic knowledge of genital differences, gender identity, sexual body parts and (non‐sexual) functions of the genitals. Knowledge of pregnancy and birth, reproduction and adult sexual behaviour was found to be very limited and decreased in the order presented here. Non‐sexually abused children appear to interpret situations that show physical intimacy between adults and children in terms of their own experiences. None of the children talked about sexual activities. Older children generally knew more than younger ones. No significant differences in knowledge between boys and girls were found. Copyright © 2000 John Wiley & Sons, Ltd.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

Gender Differences in Sexually Abused Children and Adolescents: A Multicenter Study in Turkey

The purpose of this study was to examine gender-based differences in abuse-related characteristics and post-abuse psychiatric disorders among sexually abused children and adolescents. The researchers retrospectively examined files, judicial reports, and social examination reports of 1,250 sexually abused youth cases. Results showed that boys were more often victimized by penetration, force, and physical violence. Incidence of sexual abuse by family members, familiar persons, and multiple persons was higher among girls. In addition, a higher rate of major depressive disorder as well as alcohol consumption and cigarette smoking were found in sexually abused girls. No difference was observed between boys and girls in terms of post-traumatic stress disorder, conduct disorder, and other mental disorders. Intellectual disability was more frequent in boys.     

A Summary of Selective Experimental Research on Psychosocial Interventions for Sexually Abused Children

This study was conducted to explore current trends in psychosocial interventions for sexually abused children through a review of recent research. Our comprehensive review is limited to published (quasi) experimental studies in the English language over a period of 2000–2013. It provides a detailed analysis of the final 18 articles that met our inclusion criteria, from the 670 potentially relevant articles that were identified. Reviewers analyzed candidate articles to determine whether they met inclusion or exclusion criteria. The retrieved studies reported positive results with respect to improvements in the negative psychosocial sequelae of child sexual abuse following the use of a diverse set of treatment strategies. Of the various interventions, cognitive behavioral therapy was shown to be the most promising type of intervention for sexually abused children. In this review, we discuss some of the implications of psychosocial interventions for victims of child sexual abuse, citing both the methodological and ethical issues that should be considered.     

Gender Differences in the Characteristics and Outcomes of Sexually Abused Preschoolers

ABSTRACT

This study examined whether sexually abused preschool boys and girls (ages 2–5) differed in terms of abuse characteristics or psychological outcomes. A retrospective chart review of 74 cases of sexually abused children (29 boys and 45 girls) treated at an urban mental health clinic in Maryland was conducted. Information was collected on: (1) demographics; (2) abuse characteristics (victim's age, type of sexual abuse, relationship to perpetrator); (3) abuse discovery pattern (accidental vs. purposeful); (4) children's symptomatology; and (5) child and familial factors. No differences were found between boys and girls in terms of the victim's age at the time of abuse, perpetrator's age, or the identity of the perpetrator. However, boys and girls experienced different forms of abuse; boys were more likely to experience fondling, oral and anal intercourse. The majority of boys and girls were abused by males, typically someone they knew (biological parent/parent figure or relative). No differences were evident in the type of disclosure; however, older children were more likely to self-disclose than younger children. Results indicated that boys exhibited more developmental delays and aggressive symptoms than girls. Clinical implications of these findings are discussed as well as recommendations for future research.     

Rorschach Responses of Sexually Abused Children

Clinicians have few reliable methods with which to accurately detect and assess the incidence of child sexual abuse. Using archival data, this exploratory study copmared Rorschach protocols of 94 sexually abused children to the Exner (1986a) norms in order to determine the potential usefulness of the Rorschach in the area of hcild abuse assessment and treatment. Subjects, both male and female and between the ages of 6 and 16 years of age, were combined into three age groups and compared to the Exner norms. Of the 18 Rorschach variables studied, 17 significantly distinguished at least one subject group from the norms. Results were consistent with findings in the literature regarding characteristics of sexually abused children. Rorschach scores suggest that sexually abused children suffer impairment in terms of emotional experience and expression, attitudes toward self and others, and perceptual conventionaliy. Future research is discussed, including the need for comparison groups and for controling several subject variables.