The duty to care and the need to split

This paper arises out of psychoanalytically oriented consultancy to teams of staff in the helping professions where there is a statutory 'duty to care'. It takes as its premise the seemingly paradoxical hypothesis that workers may need to split off part of their emotional experience in order to preserve their own mental health and provide reliable services to their clients. I argue that while a professional 'duty to care' requires us to be emotionally 'in touch', the demands of our clients together with the demands of the institutional response to the 'duty to care' cause us to split off parts of our awareness. I also argue that provided the splitting does not become extreme we are doing no more or less than the rest of society. In other words, there is a degree of 'normal splitting' which numbs our awareness of danger and destructiveness and seeks to protect us from too much anxiety and pain. Yet if professional workers are charged with the responsibility of assessing risk and acting accordingly for the protection of all concerned they need ways of being 'in touch' (re-integrating the splits) for some or enough of the time. Finally, I will describe ways of being 'in touch', illustrating the difficulty and the pain of re-integrating the splits and some of the insights that can arise out of this work with examples from my consultancy work.     

The Resilient Survivor—A Student Social Worker's Journey on Placement

This paper represents the continuation of my ‘personal and professional journey’ from social work student to social work practitioner focusing on my first Practice Learning Opportunity (PLO). Recognising the potential impact of childhood sexual abuse (CSA) in a classroom environment is as important as the potential impact on actual practice learning and practice. This is salient in the real world of social work practice as the potential misuse of a painful childhood experience has greater ramifications. Utilising the ideas and assumptions of social constructionism (including context and multivocality) the significance of silence from social work educators shall be examined in relation to self-disclosure as a means of aiding PLO learning and practice. This paper will also focus on the concept of critical reflection and its significance in exploring the transferability of a childhood experience such as CSA and personal and professional dilemmas regarding self-disclosure. This paper concludes by highlighting areas for consideration for both students and social work educators and conveys an important message regarding the importance of communication between students and social work educators.     

Sentencing Male Sex Offenders Under the Age of 14: A Law Reform Advocacy Journey in Hong Kong

The common law presumption that a boy under the age of 14 is incapable of sexual intercourse has provoked controversial debates in Hong Kong. This article describes a 6-step advocacy journey to examine how community efforts have helped modify this law so that juvenile male sexual offenders under the age of 14 who have committed the crime of having sexual intercourse with underage females can be sentenced to receive appropriate treatment. Seven court cases provided by the magistrates’ courts in Hong Kong were used in this advocacy effort for the removal of the presumption in July 2012. Although this effort has yet to reveal signs of effectiveness, it represents greater public awareness about providing rehabilitation appropriate for juvenile sex offenders through a formal sentence. Restorative justice, as opposed to retributive or punitive justice, places an emphasis on rehabilitation of the offender and restoration of victims to a place of wholeness.     

Medical Assessment of Children Who Have Been Recently Raped

No abstract available for this article.     

The Use of a Physician-Social Worker Team in the Evaluation of Child Sexual Abuse

No abstract available for this article.     

Current Practices in Residential Treatment for Adolescent Sex Offenders: A Survey

SUMMARY

A list of all treatment facilities for adolescent sex offenders that described themselves as inpatient or residential was requested from the Safer Society Foundation in Brandon, Vermont. A total of 203 such facilities were identified in this manner. Each was sent a questionnaire regarding their policies and practices. Of the 50 questionnaires that were returned, 49 were usable. Items on the questionnaire dealt with major phases of operating a residential program, including number of beds, average daily census, number of males and females in treatment, testing and assessment procedures, most frequent diagnoses, average IQ of patients, abuse history, therapeutic approaches used, number and types of individual/group treatment sessions per week, qualifications of therapists, average length of treatment, and follow-up research on treatment.     

Training Knowledge of Professionals on Specific Topics in Child Sexual Abuse

This exploratory study examined the training background and self-reported level of knowledge of a group of professionals on specific topics in child sexual abuse. The results show that while the vast majority of those working with adult victims, female victims, and incest victims have received training, many professionals working in the area of child sexual abuse treatment have not had training on topics directly related to their work. It was found that fewer than 40% of those working with female offenders, victims and offenders who are gay or lesbian, victims and offenders who have developmental disabilities, or in cases where cultural issues are relevant, have had training in working with these types of cases. Those professionals who had received training reported feeling more knowledgeable on these topics than did those without training. It is recommended that graduate degree programs and continuing education programs examine their offerings in the area of child sexual abuse.     

Efficacy of a Group Therapy for Sexually Abused Adolescent Girls

ABSTRACT

The effects of a group therapy program for teenage girls reporting child sexual abuse were evaluated by means of a pretest/post-test design with a control group. The psycho-educational intervention consisted of an average of 20 weekly two-hour meetings. Results of the repeated analyses of variance (ANOVA) revealed a sig-nificant improvement in youth participating in the therapy when compared with the control group on measures of post-traumatic stress, internalizing and externalizing behavior problems, coping strategies, relation- ship with the mother, and sense of empowerment. The findings suggest that the group therapy offered by the Centre d'Intervention en Abus Sexuels pour la Famille (CIASF) was effective in reducing symptoms for sexually abused teenagers.     

It's All a Matter of Attitude

Abstract

Studies have consistently documented an incidence rate of between 25% and 50% for domestic violence in gay and lesbian relationships. These numbers suggest that the gay and lesbian community is dealing with a significant mental health issue, one that is not being adequately addressed. If mental health professionals can be taught ways to assess for domestic violence in their work with sexual minorities, those persons being abused can learn strategies for ensuring their physical safety.