The Effect of the Primary Caretaker's Distress on the Sexually Abused Child: A Comparison of Biological and Foster Parents

Secondary trauma experienced by sexually abused children has only recently been explored in the literature. The scant findings suggest that out-of-home placement, the family's reaction to disclosure, and the emotional functioning of mothers may impact upon the emotional well-being of the sexually abused child. This study reports findings of data collected from 26 biological and 45 non-relative primary caretakers of molested children (n = 71). The data indicate significant differences between the two groups of caretakers with regard to maternal distress and support, and a strong relationship between the distress of the caretaker and symptomatology of the child. Significant predictors of child symptomatology and maternal support are reported, and recommendations for practice and policy applications are discussed.     

Staying safe: strategies for qualitative child abuse researchers

Undertaking interview‐based research with victim/survivors of child abuse can be difficult and challenging for researchers. Much has been written about the impact of research on participants, but researcher effects are less explored. This paper reviews the literature on sensitive interview‐based research and child abuse research. The theoretical underpinnings of researcher trauma are outlined and challenges identified and related to child abuse research using researcher reflections from the authors' interview‐based research with children who have been abused and young mothers who were sexually abused in childhood. Strategies and recommendations are developed to minimise child abuse researcher trauma. Copyright © 2009 John Wiley & Sons, Ltd.     

Attachment Quality and Post-treatment Functioning Following Sexual Trauma in Young Adolescents: A Case Series Presentation

Children and adolescents who suffer sexual abuse evidence symptoms that may persist into adulthood. Attachment theory may lend some insight into the psychological sequelae following sexual trauma. A clinical case series presents four sexually abused young adolescents from the first author's clinical caseload. Each case is rated regarding the quality of attachment, the severity of trauma, and the child's functioning at the time of follow-up. Ratings are made by the first author and qualified by a second clinician who is familiar with each case. Findings suggest that those youngsters who had the benefit of a strong and secure attachment evidence more positive outcome at follow-up.     

Ghosts in the nursery revisited

In the last decades new research findings have illuminated many of the factors that affect the mental health development of the pre-verbal child. Attachment theory has emerged as a central concept which has great applicability to the clinical field of infant-mental health. The new knowledge base has been utilized by clinical research programs to develop new models of clinical intervention programs with infants-at-risk and their families. This article describes some of the theoretical and research findings which can be translated to, and enhance, traditional child welfare practice. The theoretical considerations are illustrated by case examples.     

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.     

Child Sexual Abuse Workers’ Emotional Experiences of Working Therapeutically in the Western Cape, South Africa

South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers’ emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world. This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews. There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants’ ways of managing sexually abused children’s material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions. To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.     

ATTACHMENT THEORY AND RESEARCH APPLIED TO THE CONCEPTUALIZATION AND TREATMENT OF PATHOLOGICAL NARCISSISM

This article focuses on the relevance of attachment theory and research in the conceptualization and treatment of pathological narcissism. It is proposed that the relational context of individual development and the interpersonal interpretative capacities that emerge as part of the attachment system may be salient factors in the etiology and treatment of narcissism. Included is an overview of research on attachment models and their correlation to adult psychopathology and to narcissistic personality disorders. It is suggested that internalization and maintenance of a “secure base” and improvement in self-reflective functioning informs and enriches the clinical treatment of adults with narcissistic features.     

Exploring the Relations Among the Nature of the Abuse,Perceived Parental Support,and Child's Self-Concept and Trauma Symptoms Among Sexually Abused Children

ABSTRACT

This study examined two resiliency factors: self-concept and perceived parental support, in conjunction with abuse factors that impact psychological functioning. Data were collected on 61 sexually abused children prior to treatment. Findings indicate that a child's self-concept was associated with all the trauma symptoms except sexual concerns and did account for a significant amount of variance in relation to trauma symptomatology. Parental support was only associated with the Dissociation and was not found to account for variance in relation to trauma symptoms. Factors specific to the sexual abuse found that when a child endured a lengthy abuse period, their self-concept was more negative.     

Boundary Ambiguity and Borderline Personality Traits: Implications for Treatment for Adolescent Girls in Foster Care

This article explores the relationship between boundary ambiguity and borderline personality traits in adolescent girls in foster care. Boundary ambiguity is a family systems concept: family members are uncertain about who is in or out of the family—in either psychological or physical presence or absence. In foster care, it can be assumed that an adolescent girl has experienced trauma significant enough to be removed from her family. The connection between early childhood trauma and attachment disruption in addition to the connection between insecure/disorganized attachment and borderline personality disorder leads to the conclusion that these same adolescents are at high risk for developing borderline personality traits. The sample consists of 40 caseworkers from New England’s child protection departments and therapists from residential programs working with adolescent girls. They completed the Shedler-Westen Assessment Procedure for Adolescents to determine the presence of personality disruption as well as a variation of Pauline Boss’s Boundary Ambiguity Scale #1, and demographic questionnaires. The results find a significant correlation between boundary ambiguity and borderline personality traits. These findings provide directions for future research in clinical treatment and child welfare policy making.     

Family Environment,Personality, and Psychological Symptoms in Adults Sexually Abused as Children

The current study examined the relationships between family environment characteristics, personality traits, and current psychological symptoms in adults with a history of child sexual abuse. Family environment characteristics, personality traits, and psychological symptoms in 18 abused and 18 nonabused college students were examined using ANOVAs and MANOVAs. Pearson product moment correlations were also performed. Results indicated significantly more dysfunctional family environment characteristics (inflexibility, poor cohesion, family dissatisfaction, and poor family communication) in the abused versus the nonabused group. There were significantly higher levels in the personality traits of neuroticism and openness to experience in the abused group; however, there were no significant differences in psychological symptoms when comparing the two groups. The implications of the results and areas of future research are discussed.     

Trauma and couples: mechanisms in dyadic functioning

Research traditionally has focused on the development of symptoms in those who experienced trauma directly but overlooked the impact of trauma on the families of victims. In recent years, researchers and clinicians have begun to examine how individual exposure to traumatic events affects the spouses/partners, children, and professional helpers of trauma survivors. The current study reports data from a larger mixed-methodology study that includes qualitative interview data from 17 individuals, coded to identify the mechanisms that may affect the couple's interpersonal functioning when there is a history of trauma exposure in one or both partners. The following primary themes were identified: role in the relationship, boundary issues, intimacy problems, triggers, and coping mechanisms. Areas for future research and clinical implications also are identified.     

Selfobject functions of the family: Implications for family therapy

The application of Self-Psychology theory to family functioning adds to our models of understanding and intervention in family therapy. This article develops a theory of the family as a supraordinate selfobject and explores diverse clinical applications of the theory. The family as a selfobject matrix enhances the self development of the child by the provision of continuity through the maintenance of proximity over time, and by an enhanced quality and quantity of selfobject responsiveness for the individual. This application of Self Psychology theory has wide implications for family therapy with children in foster care, family therapy with elderly couples coping with dementia in one spouse, and family therapy as a component of treatment with suicidal adolescents.     

Trauma Symptoms: Relationship With Career Thoughts,Vocational Identity,and Developmental Work Personality

Knowledge of traumatic events and how trauma symptoms relate to social and psychological well‐being continues to grow. One aspect of an individual's functioning that may be affected by exposure to traumatic events is the ability of the individual to engage in career‐ and work‐related activities (D. H. Coursol, J. Lewis, & L. Garrity, 2001). The current study examines the relationship between trauma symptoms and the career development process of 131 college students. Results indicate a significant relationship between higher levels of trauma symptoms and higher levels of dysfunctional career thoughts and lower levels of work personality. Implications for career counselors are discussed.     

Nonoffending Parent Expectations of Sexually Abused Children: Predictive Factors and Influence on Children's Recovery

This study examined the influence of parental expectations on the functioning of sexually abused children. Participants included 67 sexually abused youth and 63 of their nonoffending primary caregivers. Parental expectations about how sexual abuse will impact children were predictive of parents' ratings of children's behavior at pretreatment, while parental expectations of children's overall future functioning were not predictive of parents' ratings of children's behavior. Parental expectations about how sexual abuse will impact their children and about their children's overall future functioning were not predictive of parents' ratings of children's behavior at posttreatment. Results highlight the influential role the sexual abuse label has in shaping parental expectations about children's functioning. Recommendations for research and intervention are discussed.     

Posttraumatic Stress and Mental Health Functioning of Sexually Abused Children

This study examined the relationship between levels of posttraumatic stress and overall mental health functioning of fifty-three sexually abused children. This study analyzes the relationships between the mental health functioning of sexual abuse victims and PTSD, using data collected from the Non-Offending Parents Project. Unlike numerous earlier studies, standardized instruments (the Child Assessment Schedule and the Child Posttraumatic Stress Reaction Index) were used for data collection. Data analysis supported the hypothesis that the posttraumatic stress level of children who have been sexually abused is associated with level of child mental health functioning. Nearly all the children in the study were experiencing a clinical level of posttraumatic stress, and were diagnosed as having PTSD. Child Assessment Schedule subscale areas which were related to posttraumatic stress level included worries, physical complaints, moods, school functioning, family, and fears.     

See no evil,hear no evil,speak no evil: assessing complex trauma in young children

Complex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings.     

“I Am Not A Victim. I Am A Survivor”: Resilience as a Journey for Female Survivors of Child Sexual Abuse

ABSTRACT

This study was designed to expand our understanding of the positive aspects of coping and resilience in female survivors of child sexual abuse. Research questions focused on women’s lived experiences of being survivors of child sexual abuse and how they have experienced resilience, developed healthy intimate relationships, and viewed themselves as sexual beings. Using a qualitative research lens of phenomenology, we captured the essence of survivors’ experiences of resilience. Although each woman’s experience was unique, similar patterns of processes and outcomes emerged as meaningful in their development of resilient and healthy sexuality and relationship functioning. However, participants emphasized resilience as a process or journey—recovery from trauma, reconceptualization of self, and development of healthy sexuality included deliberate efforts occurring over time. Implications for future research and practice using a positive lens of resilience are provided.     

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

The short‐ and long‐term consequences of childhood sexual abuse have been extensively reported. However, for many years there has been an absence of psychological conceptual frameworks for understanding and treating abuse trauma symptoms. This paper reviews a number of outcome studies for the treatment of child sexual abuse where a post‐traumatic stress disorder (PTSD) conceptualization was used to plan treatment interventions. The paper concludes that, contrary to some concerns expressed by clinicians, sexually abused children and their non‐abusing carers can signi?cantly bene?t from cognitive behavioural interventions which use reliving and confrontation of the abusive experience. Notwithstanding this, there is a need for further controlled outcome research of cognitive behavioural interventions using reliving techniques to explore how and why these interventions help in reducing abuse‐related PTSD symptoms. Copyright © 2004 John Wiley & Sons, Ltd.     

Cultural and religious influences in maternal response to intrafamilial child sexual abuse:charting new territory for research and treatment

The role of culture when providing services for families in the wake of child sexual abuse disclosure is a charged issue although surprisingly little attention has been given in the research literature to this. This article reports the findings of a grounded theory study exploring facets of maternal response, and aspects of more and less supportive responses, to children who were sexually abused by the mother's intimate partner. Ten mothers, chosen on the basis of theoretical sampling, provided information through in-depth interviews to understand how they responded emotionally and behaviourally to their child's disclosure. As well, three service providers were interviewed as key informants. The research revealed cultural and religious influences as affecting how mothers made meaning of the sexual abuse and the actions they took. Mothers from cultural backgrounds that adhere to rigid patriarchal norms identified themes of intense value conflicts regarding family preservation, loyalty binds between the perpetrating partner and child victim, and anxieties around being alienated from their extended family and ethnic community. They also reported that their cultural belief systems were not well understood by service providers. In parallel, helping professionals identified cultural issues as presenting barriers for engaging with some clients. Practice implications and research directions are discussed.     

Domestic Violence,Children's Agency and Mother–Child Relationships: Towards a More Advanced Model

Although domestic violence research increasingly recognises children's agency, this awareness has not extended to our understanding of children's relationships with their abused mothers. Findings suggesting that some children actively support their mother, and encourage her to leave the perpetrator, have been consistently under‐discussed. This article argues that the model of parent–child relationships used by most domestic violence research sees children as passive and contributes to mother‐blaming discourses. Analysing key quantitative and qualitative research, I suggest that a more sophisticated model of parent–child relationships is needed to understand how children's agency affects them, their mothers and the domestic violence situation.