Child sexual abuse evaluations: adherence to recommendations

Sixty-eight parents of children with alleged child sexual abuse (CSA) were surveyed 4 months after visiting an interdisciplinary CSA evaluation clinic in order to examine the extent to which recommendations were recalled and implemented. Of those parents for whom specific recommendations were provided, 9% recalled recommendations for medical follow-up, 79% recalled recommendations for child therapy, and 43% recalled recommendations for parental therapy. Families were more likely to receive and adhere to recommendations when there were behavioral problems and a strong indication of CSA. To improve communication with families, the reasons for recommendations must be clearly conveyed, and possible barriers to implementation should be anticipated and addressed. In addition, recommendations need to be realistic, and professionals need to facilitate the implementation of their treatment plan.     

Knowledge,Attitude and Practice of Child Sexual Abuse Prevention among Parents of Children with Hearing Loss: A Pilot Study in Beijing and Hebei Province,China

ABSTRACT

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls’ parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice.     

Toward a culturally sensitive child sexual abuse prevention program for latinos

A culturally sensitive sexual abuse prevention program for Latinos is proposed which makes recommendations regarding style of interaction, discussion topics of importance, and other areas which need he considered in the design and implementation of such a program. The role of the child, parents, professionals, and others involved is discussed.     

EDITORIAL

ABSTRACT

Many states are implementing concurrent planning as a means to expedite permanency planning for children in foster care; however, the parameters for this strategy vary significantly and the research regarding outcomes is sparse. This qualitative study sought to examine the experiences of child welfare experts, parents, foster parents and caseworkers regarding concurrent planning in New York State. The findings indicate that although concurrent planning is generally understood, training, services and supports are lacking for parents, foster parents, and caseworkers in the implementation of concurrent planning. In addition, although all parties see concurrent planning as an effective strategy, crafting and maintaining working relationships between key parties is challenging. Clearer communication with parents, joint training of caseworkers and foster parents, improved information disclosure, and fuller involvement of foster parents in the planning process are among the recommendations for improving practice.     

Slipping through the cracks: Examining the realities of a child-friendly prison system

IntroductionThe health effects for children with incarcerated parents, and methods to improve children's experience of the justice system, are under-researched areas. While some work has been done to illuminate these concerns, practical implementation of a “child-friendly prison” has been slow.AimsA Health Directorate-funded project examining children's interactions with the Australian Capital Territory (ACT) justice system was conducted in 2013, which made a number of recommendations. The current study sought to examine the ongoing impacts of parental incarceration for children in the ACT and follow up on the recommendations.MethodsSemi-structured interviews were conducted with seven key stakeholders with a relationship to the research area. The interviews were summarised, and a thematic analysis was carried out to identify relevant ideas. Results from recent Detainee Health and Welfare Surveys were used to estimate the number of children affected.ResultsThe findings from the interviews concluded that little action was taken in response to the original report, that children's rights and agency were compromised, that the prison lacked accessibility, that consistent and individualised information should be provided to affected children, and that a previously operational homework program should be reinstated. Model facilities were identified.ConclusionThree broadly-applicable recommendations were made in response to the data from the surveys: increasing accessibility of public transport, the establishment of a child liaison officer at prisons, and maintaining extended family visits.     

For the Love of Fluffy: Respecting,Protecting, and Empowering Transitional Objects in the Context of High-Conflict Divorce

ABSTRACT

Transitional objects are those idiosyncratically determined, beloved blankies and stuffed animals that communicate an absent parent’s affection. As such, transitional objects serve the short-term need to cope with separation, and the long-term need to move toward autonomy. This article discusses the value, use, and misuse of transitional objects in the context of coparental conflict. The concept of alienation-by-proxy is introduced. Specific recommendations are provided, including the therapeutic creation and empowerment of transitional objects to assist children experiencing separation anxiety, consideration of the role of transitional objects in child custody evaluations, and the court’s responsibility to encourage litigating parents to respect the child’s needs for transitional objects.     

Barriers to Utilization of Mental Health Services amongst Male Child Sexual Abuse Survivors: Service Providers’ Perspective

ABSTRACT

Most research on child sexual abuse has been on survivors to the exclusion of service providers. This paper focuses on one group of findings from a larger qualitative study. The aim of the paper is to identify existing services and highlight the gaps in the current programs available for male CSA survivors from the perspective of service providers. Semi-structured interviews were conducted with 11 mental health service providers, recruited from two Southern and Central Ontario cities. Findings presented here report service providers’ perspective of gaps in services for male CSA survivors. “Limited Male CSA Programs”, “Institutional Barriers”, “Attitudinal Barriers”, and “Systemic Gaps” emerged as four major themes from the data analysis. Findings demonstrate the need to re-evaluate currently available service and highlights gaps in mental health service available for male CSA survivors. Implications for policy, practice, and research are discussed.     

Mental Health Consumer and Carer Participation in Professional Education: ‘Getting There Together’ for Children of Parents with Mental Illness and Their Families

Abstract

‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘… the whole family, and how the child fits into the picture’.     

The Prevalence of Child Sexual Abuse among Slovak Late Adolescents

ABSTRACT

The present study aimed to assess the prevalence and characteristics of child sexual abuse (CSA) in a large-scale sample of Slovak late adolescents. Randomized cluster sampling was used to sample 2186 students in their final school year of secondary school with mean age of 18.6 years (SD = .7 years). The study employed the Child Sexual Abuse Questionnaire consisting of multiple behavior-specific questions. The prevalence of CSA was analyzed separately for three clusters of CSA and gender. The prevalence of non-contact forms of CSA was 40.6% among girls and 17.7% among boys. CSA with physical contact without penetration was reported by 30.2% girls and 11.6% boys. The prevalence of CSA with penetration was 5.6% among girls and 1.3% among boys. More than half of CSA occurred between 16 and 18 years of age. The severity of abuse was positively associated with acquaintance to the perpetrator. Roughly 43–56% disclosed the abuse to another person. The majority of disclosed CSA was revealed to peers and partners. A negligible proportion of CSA instances were reported to the police. Prevention activities should consider a broad spectrum of CSA in order to counteract tendencies to associate CSA only with unwanted sexual intercourse.     

The “Wall of Fear”: The Bridge Between the Traumatic Event and Trauma Resolution Therapy for Childhood Sexual Abuse Survivors

ABSTRACT

A multitude of published books and papers on child sexual abuse (CSA) describe symptoms, long-term effects, and therapy for survivors of abuse. However, the parallels between the nature of the sexual trauma event(s) as originally experienced by the victim and the therapeutic process into which the survivor later becomes engaged have not been reported. This paper attempts to fill that gap and proposes that the concept of a “Wall of Fear” is the bridge connecting the two. In the first part of the paper, a model of the CSA experience based upon Furniss (1991) will be explained in order to point out the basis for the dissociation and other symptomology demonstrated by the CSA victim. Following that, the stages of therapy will be mapped out, with special attention to the concept of the Wall of Fear (Oz, 1999) and traumatic memory resolution (abreactions) and with reference to the experience of the original traumatic events. Therapist fear of decompensation will be addressed.     

Abusers gaining custody in family courts: A case series of over turned decisions

Abstract

This article presents findings and recommendations based on an in-depth examination of records from 27 custody cases from across the United States. The goal of this case series was to determine why family courts may place children with a parent that the child alleges abused them rather than with the nonoffending parent. We focused on “turned around cases” involving allegations of child abuse that were at first viewed as false and later judged to be valid. The average time a child spent in the court ordered custody of an abusive parent was 3.2?years. In all cases we uncovered the father was the abusive parent and the mother sought to protect their child. Results revealed that initially courts were highly suspicious of mothers' motives for being concerned with abuse. These mothers were often treated poorly and two-thirds of the mothers were pathologized by the court for advocating for the safety of their children. Judges who initially ordered children into custody or visitation with abusive parents relied mainly on reports by custody evaluators and guardians ad litem who mistakenly accused mothers of attempting to alienate their children from the father or having coached the child to falsely report abuse. As a result, 59% of perpetrators were given sole custody and the rest were given joint custody or unsupervised visitation. After failing to be protected in the first custody determination, 88% of children reported new incidents of abuse. The abuse often became increasingly severe and the children's mental and physical health frequently deteriorated. The main reason that cases turned around was because protective parents were able to present compelling evidence of the abuse and back the evidence up with reports by mental health professionals who had specific expertise in child abuse rather than merely custody assessment.     

Parental Discussion of Child Sexual Abuse: Is It Associated with the Parenting Practices of Involvement,Monitoring, and General Communication?

We investigated whether parents who reported more positive parenting practices (i.e., monitoring, involvement, and communication) reported more discussion of child sexual abuse (CSA) with their children. Parents from Australia and the UK (N = 248), with children aged 6 to 11 years, completed an online survey. About half of parents reported directly discussing CSA, whereas 35% reported telling their children that CSA perpetrators may be family members. Rates of discussion were higher for other CSA-related topics such as body integrity and abduction. Correlational analyses showed that parents who reported speaking to their children about CSA also reported more positive parenting practices, more discussion of other sensitive topics, and assessed CSA risk for children (in general) to be higher. Discussion of CSA risk was not associated with parents' CSA knowledge, confidence or appraisal of own-child risk. Parents higher in positive parenting believed their children to be at less CSA risk. Parents who appraised higher own-child risk reported less positive parenting practices and were less confident about their parenting and their ability to protect their children from CSA. The findings are the first to report on the associations of parenting practices with parents' CSA discussion with their children.     

Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents

Background and objectiveChildren in foster care have complex mental health needs and receive high rates of psychotropic medications. Rarely can foster parents make legal decisions about treatment, yet they are intricately involved in the child's life and responsible for the child's safety and well-being. We aimed to conduct the first study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care.MethodsWe conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years. The state child welfare agency sent information about the study via email to all foster and adoptive parents for whom they had email contact. Interviews queried parents' knowledge and attitudes toward psychotropics, engagement in decisions, and recommendations for the decision-making process. Interview responses were coded and synthesized using mixed inductive and deductive methods in Dedoose software.ResultsChildren came into care on an average of four psychotropics. Parents reported receiving little information about the medications and finding information on their own. Parents acknowledged the potential benefits of medications, yet attitudes were largely against their use. Internal and external pressures for and against the use of medications were described. Many parents felt left out of the decisions and recommended team decisions.ConclusionsEfforts to improve foster parents' knowledge of medications, side effects, and monitoring, as well as team decision protocols, are sorely needed to improve decisions for this population.     

Parental knowledge of child sexual abuse symptoms

The purpose of this study was to investigate parental knowledge of symptoms of child sexual abuse (CSA), and to determine the factors associated with that knowledge. A total of 150 parents listed symptoms of CSA in the following areas: physical/medical, emotional, sexual behavior, and behavior towards others. Results suggest that, although most parents are familiar with some of the symptoms of CSA, they are more likely to know emotional or behavioral reactions which could be suggestive of many other life stressors. Parents with higher socioeconomic status listed more symptoms, but race and parenting experience were not significant factors. Results suggest the need to inform parents of more indicative physical or sexual symptoms, and to target parents of lower SES background in awareness efforts. doi:10.1300/ J070v15n04_01.     

The Relationship between Social Dominance Orientation and Child Sexual Abuse Credibility Assessment

ABSTRACT

Allegations of child sexual abuse (CSA) across various contexts have often been denied or ignored by a multitude of people, including those who do not personally know the alleged perpetrators or victims. The lack of belief of children’s CSA reports is problematic, as this may affect the child’s adjustment, the consequences for the alleged perpetrator, and the likelihood of other victims reporting abuse that they experienced. One plausible explanation for low credibility is the variable of social dominance orientation. In the current study, a diverse sample (N = 60) read a hypothetical vignette of a CSA allegation, rated the credibility of the child, and completed the Social Dominance Orientation-7 scale (SDO-7). Results supported that high social dominance orientation predicts low credibility ratings of the child’s CSA allegation. Findings may impact how clinicians and investigators approach the assessment of credibility of CSA allegations, how they appraise the opinions of others about such credibility, and jury selection in the court system.     

Preventing child sexual abuse: parents' perceptions and practices in urban Nigeria

This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents disagreed with common child sexual abuse myths. In addition, almost all parents ( >90%) reported communicating with their child(ren) about stranger danger. However, about 47% felt their children could not be abused, and over a quarter (27.1%) often left their children alone and unsupervised. There were no significant variations in the perceptions of child sexual abuse and communication practices. The implications of findings for child sexual abuse prevention are discussed.     

Commentary on Walker,Brantley, and Rigsbee's (2004) “A Critical Analysis of Parental Alienation Syndrome and Its Admissibility in the Family Court”

Abstract

In this response to Walker et al. (2004), we explain our perspective, recent research, and recommendations in order to correct some misunderstandings of our work on alienated children. Then we address some important issues that Walker et al. have raised that deserve the attention of the field. These include whether a child necessarily needs a relationship with both parents; when we should give children their own voice and respect their self-determination, whether children who reject a parent are significantly emotionally troubled or at-risk for emotional or mental disorders in the future; and whether they need court-ordered intervention (despite the child's and aligned parent's resistance or objections). Finally, we address what are the nature, purpose, and prognosis for mandated treatment.     

Attributions of Blame among Victims of Child Sexual Abuse: Findings from a Community Sample

ABSTRACT

According to the attribution theory, negative outcomes of child sexual abuse (CSA) are thought to vary depending on whether CSA victims attribute the abuse to internal or external factors, respectively, self-blame and perpetrator-blame. Therefore, the purpose of this study was to identify abuse characteristics and attitudes that influence blame attributions among CSA victims from a community sample. Data from respondents with a history of CSA (N = 1,496) have been used in predicting blame attributions; perpetrator-blame, self-blame, or both. Results from a multinomial logistic regression analysis showed that attitudes toward gender roles had a significant effect on blame: victims were more likely to blame themselves when they endorsed more conservative gender attitudes than victims with more liberal attitudes. Implications for this finding are discussed.