The Experience of Trauma Recovery: A Qualitative Study of Participants in the Women Recovering from Abuse Program (WRAP)

ABSTRACT

The efficacy of intensive group treatment programs for child maltreatment has been established. The aim of this qualitative study was to understand how women with a history of child maltreatment experienced the Women Recovering from Abuse Program (WRAP), an existing intensive group treatment program. Seven women were interviewed following their participation in WRAP. Three themes emerged: Breaking Trauma-Based Patterns, Doing Therapy, and The Healing Journey as a Continuous Process. These findings deepen our understanding about how participants view the recovery process. Theoretical and clinical implications are discussed.     

The experience of smoking in recovery settings: an ecological momentary assessment pilot study

ABSTRACT

Smoking continues to be the leading cause of preventable death in the United States, and people with substance use disorders (SUD) smoke at higher rates compared to their non-using counterparts. Individuals with SUDs may have different emotional experiences and expectancies than those without. The current study explored the relationship between smoking and emotional experiences among residents in recovery homes, a population that little is known about regarding their tobacco addiction. Using ecological momentary assessment (EMA), significant emotional differences were found between nicotine users and nonusers. Implications of these findings could help in the development of interventions directed toward reducing smoking cessation.     

The dream as a vehicle for the recovery of childhood trauma

Gertrude and Rubin Blanck (1979), drawing on Freud's discovery that a dream may lead to the recovery of forgotten childhood experiences, have shown how certain dreams may provide access to the pattern of the early mother-child relationship and to critical events that occur before the ego is capable of processing experience adequately. Drawing from their considerations, this paper demonstrates how a dream was employed to reconstruct a pattern of early chronic stress trauma which had contributed to a repetitive pattern of self destructive behavior in a depressed woman. This reconstructive effort helped start the difficult work of diminishing the painful impact of the traumatic past and paved the way for a beginning identification with a protective object, the therapist.     

The Relationship Between Child Sexual Abuse and Alexithymic Symptoms in a Population of Recovering Adult Substance Abusers

ABSTRACT

Recovering substance abusers with a history of childhood sexual abuse (n = 69) or no history of childhood sexual abuse (n = 68) completed the Toronto Alexithymia Scale (TAS) and a background survey assessing demographic data and (In the case of sexually abused respondents) parameters of the childhood abuse experienced. The sexually abused group scored significantly higher than the non-abused group on the TAS. Within the abused group, measured alexithymic symptomatology was found to be related positively to the duration of the abuse. Alexithymia was significantly higher when the sexual abuse first occurred after the victim had reached the age of 12, when a perpetrator of the sexual abuse was a father or stepfather, and when the abuse involved oral, vaginal, and/or anal penetration. Results were interpreted as indicating that the development of alexithymic symptoms may represent another defense victims may employ to insulate themselves from painful affect, along with dissociative symptoms and substance abuse, which have been shown previously to characterize adult survivors of child sexual abuse.     

The Child Abuse Risk Evaluation Dutch Version (CARE-NL): A retrospective validation study

Abstract

The Child Abuse Risk Evaluation – Dutch version (CARE-NL) is a structured professional guideline for assessing the risk of all types of child abuse. The CARE-NL comprises 18 risk factors: eight Parental characteristics, three Parent-Child interaction factors, five Family factors, one Child vulnerability factor, and an extra factor for child sexual abuse risk. We examined interrater reliability and predictive accuracy of the instrument in a retrospective study at Advice and Reporting Centers on Child Abuse (ARCCA) in The Netherlands. The ARCCA files contained limited information on Parental risk factors, while parental characteristics, such as mental disorder and substance abuse, are the most important risk factors for (repeated) child abuse. On the other hand, the majority of the files included ample information on child and family characteristics. The CARE-NL could be reliably coded by trained raters and the predictive accuracy for out-of-home placement (AUC = .73) and placement of the child under court supervision (AUC = .78), at two years follow-up, was adequate. Use of the CARE-NL ensures that the assessment of the risk of child abuse focuses on the most important, empirically based risk factors in a structured and coherent way.     

Research notes: The effects of research on participants: findings from a study of mothers and employment

The article explores a neglected topic – the effects of research on participants. At the end of a three year longitudinal research project concerning mothers return to the labour market after maternity leave, participants (mothers) were asked to assess their experiences of taking part in the research process. The paper examines three particular aspects of the research process which have important consequences for participants: the theoretical framework and research design, the research methods, and the study findings. A situation where there is a close match between the concerns and characteristics of the researchers and the researched is likely to benefit the project and participants alike.     

“The Abuse of Older Australians (Elder Abuse)”: Reform Activity and Imperatives

ABSTRACT

Significant national reform activity is occurring that concerns the abuse of older people by trusted others. This includes an Australian Law Reform Commission report entitled Elder Abuse – A National Legal Response (2017), and the adoption in 2019 of the first ever “National plan to respond to the abuse of older Australians (elder abuse)”. While service responses in this field largely exist at, and will continue to be provided at, state and territory level, this article considers current and needed reform initiatives in a field of increasing national government attention.

IMPLICATIONS

• The adoption of the first ever national plan concerning the abuse of older people in Australia adds significant impetus and direction for reform in this key social policy area.

• Most service and regulatory reforms aimed at improving responses to the abuse of older people will occur at state and territory level.

• The breadth of likely and necessary reforms is significant, ranging from policing practices through to guardianship law reform.

     

Gambling-related embezzlement in the workplace: a qualitative study

People with severe gambling problems typically first spend all their available money on gambling and then resort to borrowing, selling personal property and other ways of procuring more money for gambling. Some problem gamblers commit economic crimes. This investigation examined gambling-related embezzlement in the workplace, an aspect of problem gambling that may severely harm the gambler, significant others and the employer. The methods used are the study of newspaper articles and qualitative interviews with 18 informants, including professionals in workplace security and drug-use prevention, therapists specializing in problem gambling treatment, counsellors from mutual support societies, and recovered problem gamblers who had embezzled. Gambling-related embezzlement often progresses in a characteristic sequence shaped by specific processes in which the gambler’s thoughts and emotions interact systemically with the monetary losses caused by participating in commercial gambling and the opportunity to embezzle money in the workplace. In this study, criminological theory of white collar crime usefully complemented psychological theories of problem gambling. It is concluded that a processual perspective, in addition to consideration of psychological and environmental factors, is valuable for understanding the progression to severe problem gambling.     

The core variables of symbolic-experiential therapy: a qualitative study

Symbolic-experiential therapists have been criticized for not adequately operationalizing symbolic theory and empirically validating their methods. Although pioneering researchers have noted that the task of studying and evaluating humanistic therapies is complex, we agree that all therapists need to be held accountable for their interventions. In this article we identify the core variables underlying symbolic-experiential therapy that emerged from a research study using grounded theory. The inductively derived conceptual framework for symbolic-experiential therapy included: (a) Generating an interpersonal set; (b) creating a suprasystem; (c) stimulating a symbolic context; (d) activating stress within the system; (e) creating symbolic experience; and (f) moving out of the system.     

Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach

ABSTRACT

The Financial Abuse Specialist Team, a partnership of professionals from diverse disciplines, volunteer their time to review cases of financial elder abuse and facilitate comprehensive service delivery. The team also advocates for legislative reform, educates the community about the problem, and trains professionals in how to recognize, prevent, and resolve financial elder abuse.     

The impact of infertility on men's work and finances: Findings from a qualitative questionnaire study

The impact of infertility on the emotional, social and relational aspects of men's lives is now more widely understood. Yet the impact of infertility on men's working lives and financial status remains largely overlooked. Drawing on a qualitative questionnaire study into men's experiences of infertility (n = 41), this article examines how work and finances are managed and negotiated during infertility, including treatment cycles. Three key themes were identified from our thematic analysis: managing infertility in the workplace; compromised job performance, (in)security and progression; the financial burden of infertility, suggesting that infertility can have significant implications for men's working lives, including their identities as productive workers. The impact had a gendered dimension, with threats to masculine‐relevant breadwinner roles and career ambitions. Awareness and management of infertility as a chronic health condition could be a useful way for employers to support disclosure of infertility and to allow men to navigate infertility and their working lives and identities in less stress‐inducing ways. This article contributes to our growing understanding of the stigma men experience in relation to infertility and how such stigma may intersect with masculinity in general and breadwinning in particular.     

Attributions of Responsibility in a Child Sexual Abuse (CSA) Vignette Among Respondents with CSA Histories: The Role of Abuse Similarity to a Hypothetical Victim

Previous research suggests that similarity to a victim may influence attributions of responsibility in hypothetical child sexual abuse scenarios. One aspect of similarity receiving mixed support in the literature is respondent child sexual abuse history. Using a sample of 1,345 college women, the present study examined child sexual abuse history, similarity to victim, and attributions of responsibility to a hypothetical victim, family member, and perpetrator in a child sexual abuse vignette. Results revealed no group differences in responsibility ratings among respondents with and without child sexual abuse histories. However, among the 133 respondents with child sexual abuse histories, results indicated that similarity to victim moderated the relationship between vignette characteristics, respondent history, and responsibility attributions. Results suggest that similarity to a victim may influence ratings in a self-preserving manner.     

From past trauma to post-traumatic growth: The role of self in participants with serious mental illnesses

Studies have shown that people with serious mental illness are more likely to have experienced trauma compared to the general population. This qualitative study employed a grounded theory approach to explore how trauma histories influenced the process of triggering, developing, and recovering from serious mental illness. Findings based on in-depth interviews with 15 participants illustrated the intersection of trauma, serious mental illness, and post-traumatic growth. Experiencing trauma compromised participants’ self-functioning, causing issues such as affect dysregulation, distorted self- and other- concepts and relationship difficulties, meaninglessness, and existential fears, all of which negatively impacted participants’ mental health and behavior. At the same time, participants with serious mental illness were able to achieve post-traumatic growth with the “transformed-self” via self-acceptance, self-exploration, self-worth, and self-fulfillment. Findings of this study have useful implications for trauma-informed care in mental health treatment. Mental health professionals should address clients’ trauma histories to prevent re-traumatization and design trauma-informed programs that use and build clients’ inner resources and strengths to promote post-traumatic growth.     

Outcomes of parental mental illness on children: a qualitative study from Iran

Children of parents with mental illness are a substantial, yet marginalized group. This study, as part of a more extensive research project, used grounded theory to explore the outcomes of parental mental illness on their children. Seventeen informants were interviewed at a mental hospital in the city of Qazvin, Iran. The participants were selected using purposeful and theoretical sampling. Interviews were analyzed using Strauss and Corbin's method. It was revealed that parental mental illness leads to five major outcomes that involve communication, mental, educational, economic, and extra roles factors. As such, it is suggested that these children should be considered within health care plans and that policy makers, nurses, and other health care providers use these findings for preventive and educational purposes.     

The opportunities and challenges of multi-site evaluations: Lessons from the jail diversion and trauma recovery national cross-site evaluation

Multi-site evaluations, particularly of federally funded service programs, pose a special set of challenges for program evaluation. Not only are there contextual differences related to project location, there are often relatively few programmatic requirements, which results in variations in program models, target populations and services. The Jail Diversion and Trauma Recovery–Priority to Veterans (JDTR) National Cross-Site Evaluation was tasked with conducting a multi-site evaluation of thirteen grantee programs that varied along multiple domains. This article describes the use of a mixed methods evaluation design to understand the jail diversion programs and client outcomes for veterans with trauma, mental health and/or substance use problems. We discuss the challenges encountered in evaluating diverse programs, the benefits of the evaluation in the face of these challenges, and offer lessons learned for other evaluators undertaking this type of evaluation.     

The process of coping following child sexual abuse:a qualitative study

This research employed both quantitative and qualitative approaches to studying the immediate and long-term coping strategies adopted by survivors of child sexual abuse, focusing on how strategies evolve over time. Qualitative findings showed that coping with child sexual abuse is not static, but changes over time. The narratives of these nonclinical survivors suggest that an adaptive outcome may be associated with a particular evolution of strategies across time, i.e., survivors reported coping predominantly by engaging in psychological escape methods initially, and then adopting cognitive appraisal and positive reframing strategies in the longer term. It appears that coping processes can affect psychological outcome following child sexual abuse. This study offers insight into the evolution of coping methods associated with an adaptive outcome.     

Women in power and power of women: the Liberian experience

ABSTRACT

Do women really improve conditions for gender equality after becoming heads of states? This study investigates if having a woman at the helm of country’s decision making processes leads to better indicators on women’s conditions. Using time-series observations for the period 2000–11, we test the hypothesis with the Liberian experience. We analyse six main gender indicators: gender equality, equality of representation in rural areas (basic community), economic rights of women, participation of women in active life, political rights of women and legislations for the protection of women against violence. Our findings do not show substantially significant changes between the first mandate of Ellen Johnson Sirleaf and the period before. In essence, we only notice positive and statistical ruptures for equality of representation in rural areas and the economic rights of women. Policy implications are discussed.     

Women migrants in the global economy: a global overview (and regional perspectives)

ABSTRACT

Huge advances have been made in deepening and expanding our knowledge of gendered migration over the last decades in both theoretical and methodological terms. Empirically it is, however, still the case that North–South migration is at the basis of most theorisations, leaving the characteristics of South–South migration at the margins. In this paper we, therefore, shift the focus to intra- and trans-regional migration in a South–South context in exploring what this means for women migrants. While feminist scholars have highlighted care and the ways in which migration challenges social reproduction as an important issue, mainstream approaches continue to focus predominantly on the ‘productive’ lives of migrant workers. With migration theories still largely drawing on the experience of South–North migration, there continues to be relatively little understanding of South–South migration’s gender dynamics, despite the fact that many of the highly feminised, yet hyper-precarious, migration flows occur intra-regionally.     

The Effect of Care Setting on Elder Abuse: Results from a Michigan Survey

This study compares abuse rates for elders age 60 and older in three care settings: nursing home, paid home care, and assisted living. The results are based on a 2005 random-digit dial survey of relatives of, or those responsible for, a person in long-term care. Nursing homes have the highest rates of all types of abuse, although paid home care has a relatively high rate of verbal abuse and assisted living has an unexpected high rate of neglect. Even when adjusting for health conditions, care setting is a significant factor in both caretaking and neglect abuses. Moving from paid home care to nursing homes is shown to more than triple the odds of neglect. Furthermore, when computing abuse rates by care setting for persons with specified health conditions, nursing homes no longer have the highest abuse rates.     

Inspiring Hope,Envisioning Alternatives: The Importance of Peer Role Models in a Mandated Treatment Program for Women

ABSTRACT

This article presents evidence from a program evaluation effort conducted with clients in a mandated treatment setting for drug-involved women charged with felony-level offenses. We present themes from qualitative interviews that stress the importance of identifying with a peer who is further along in recovery as a crucial mechanism for instilling hope and fostering program engagement. We also provide survey data that shows that a client's ability to imagine a life without using drugs, at intake, is a significant predictor of program success. Finally, the Stages of Change Readiness and Treatment Eagerness scale did not show any significant correlations with program success in this population. All women entered this program from very challenging situations, but we conclude that those who enter with the least hope and smallest (or absent) vision of any alternative future are especially vulnerable for a bad outcome. We urge researchers and practitioners to further explore the ways in which connections with peer role models facilitate engagement and successful outcomes; and to systematically evaluate the effect of interventions designed to foster such connections on program outcomes.