Clinically abusive relationships in an unselected birth cohort: men's and women's participation and developmental antecedents

In an unselected birth cohort (N=980, age 24-26 years), individuals in abusive relationships causing injury and/or official intervention (9% prevalence) were compared with participants reporting physical abuse without clinical consequences and with control participants who reported no abuse, on current characteristics and prospective developmental risks. In nonclinically abusive relationships, perpetrators were primarily women. In clinically abusive relationships, men and women used physical abuse, although more women needed medical treatment for injury. Women in clinically abusive relationships had childhood family adversity, adolescent conduct problems, and aggressive personality; men had disinhibitory psychopathology since childhood and extensive personality deviance. These findings counter the hibitory assumption that if clinical abuse was ascertained in epidemiological samples, it would be primarily man-to-woman, explained by patriarchy rather than psychopathology.     

Child sexual abuse and adolescent prostitution: a comparative analysis

In several studies, child sexual abuse has been identified as a characteristic of adolescent prostitution. The implication of these findings, especially for girls, is that the two phenomena are related in that childhood sexual abuse perhaps leads to prostitution. The present study explored the relationship between sexual abuse and adolescent prostitution by comparing 70 sexually abused children with 35 prostitution-involved children on 22 variables. Findings suggest that the relationship is not directed, but involves runaway behavior as an intervening variable. It is not so much that sexual abuse leads to prostitution as it is that running away leads to prostitution. Implications for treatment of both sexually abused and prostitution-involved children also are discussed.     

Comorbidity and Related Factors Among Ethnically Diverse Substance Using Pregnant Women

Studies have established that comorbidity needs to be considered when assessing and treating substance-using clients. This study explores course of treatment, risk factors, and drug-related issues among 192 ethnically diverse pregnant women who were actively using drugs at admission to a residential treatment program. Findings revealed that course of treatment is more difficult for comorbid clients who perceived more treatment barriers than noncomorbid clients. Comorbid clients were more likely to have a history of attempting suicide but no more likely to have been reported for child abuse or charged with a crime. Comorbid clients reported greater severity of alcohol use but did not differ from noncomorbid clients regarding drug of choice. Comorbid clients were no more likely to leave against treatment advice, and noncomorbid clients were no more likely to complete treatment. Findings suggest that sensitivity to comorbidity issues is crucial to retaining comorbid clients in treatment.     

Connections Between Childhood Abuse and HIV Infection

This study examined the incidence of childhood sexual and physical abuse in 52 human immuno-deficiency virus (HIV) infected adults. Behaviors and dynamics associated with unresolved childhood abuse (revictimization, sexual compulsivity, chronic depression, and alcohol and other drug abuse) are discussed in light of those behaviors and dynamics that increase a person's risk of exposure to the virus causing Acquired Immune Deficiency Syndrome (AIDS). lnterview results showed that 65% of those infected reported physical or sexual abuse in childhood. The prevalence of adult survivor characteristics was also examined, and responses were compared based on HIV transmission modes. Recommendations for counselors working with HIV-infected clients are also provided.     

Opioid Substance Abuse Among Occupational Therapy Clients

This study examined opioid substance abuse among clients of occupational therapists. A sample of 500 occupational therapists, representing five targeted clinical practice areas, was randomly selected from American Occupational Therapy Association membership. Of these, a total of 182 participants ultimately responded to postal surveys. Results found one third considered opioid substance abuse a problem at their facility, and over half reported having one or more clients known to be or suspected of abusing opioids. Moreover, one in five reported having a client exhibit symptoms of overdose. Recommendations for a concerted response by the profession of occupational therapy to this nationwide epidemic are presented.     

Client perspectives: The therapeutic challenge of domestic violence counselling – a pilot study

Aims: This qualitative pilot study explored the perceptions of four female domestic violence clients regarding counselling they had concluded in order to identify a preliminary client‐preferred domestic violence counselling approach. Method: Semi‐structured interviews asking about significant events during counselling were held. An adapted grounded theory and narrative methodology was used. Results from the analysis were reviewed with two of the participants. Participants were offered additional counselling support if required after the research interview. Results/Findings: Domestic violence clients found starting counselling particularly difficult after years of keeping the abuse to themselves. Participants actively withheld and managed information for several sessions and needed to know they had time to explore their experiences. The counsellor being consistent and non‐judgemental, and understanding domestic violence and its effects was helpful. Having a clear ending was appreciated by the participants. Discussion: The initial development of the therapeutic relationship benefited from active discussion of how domestic violence could affect behaviour and emotions. Good early therapeutic relationships showed elements of the three main psychological schools. Participants benefited from a pro‐active discussion of endings. A key limitation of this research is the small sample size. Implications for practice: The research suggests that counsellors would benefit from knowledge and skills from different psychological schools and specific training in domestic violence. Allowing flexibility on the number of sessions available to clients may be helpful. Conclusions: Further work is required to explore these preliminary findings. However, early indications suggest that domestic abuse clients may benefit from non‐time‐limited specialist counselling services.     

"YOU CAN'T HUSTLE ALL YOUR LIFE": AN EXPLORATORY INVESTIGATION OF THE EXIT PROCESS AMONG STREET-LEVEL PROSTITUTED WOMEN

Between 1998 and 1999, 43 street-level prostituted women were interviewed regarding their developmental experiences, including prostitution entry, maintenance, and exit attempts. Three years later, 18 of the original 43 participants were located and interviewed. This exploratory follow-up investigation focused on the women's life experiences between the two points of contact, with emphasis on sex-industry exit attempts. Five women had maintained their exit efforts and had not returned to prostitution, nine had returned to both prostitution and drug use, and one had returned to prostitution only. Three additional women had violated parole and been reincarcerated. Themes evident among those who were able to stay out of prostitution and refrain from substance use are compared to those whose exit attempts had not been successful. Suggestions for intervention and outreach are presented, as are directions for future work.     

Evaluation of an Air Force Child Physical Abuse Prevention Project Using the Reliable Change Index

Three hundred and seventy-nine parents at 25 Air Force bases participated in a collaborative child physical abuse prevention project designed by the United States Air Force Family Advocacy Program and Father Flanagan's Boys' Home (Boys Town). These participants were active duty or civilian employee parents and their spouses who completed the Boys Town Common Sense Parenting ® program as part of a comprehensive prevention effort. We hypothesized that participants would report decreased child behavior problems, improved relationships with family members, and reduced risk for child physical abuse after attending parenting sessions. Results supported this hypothesis. The data were also analyzed to determine the frequencies of individual parents who made statistically reliable changes on the dependent measures using Jacobson's Reliable Change Index. Nineteen to 30% of the participants reported significant improvement in the areas assessed. Parents who improved in abuse risk were at a higher level of risk and were less satisfied with family relationships prior to their participation than those who did not change. Implications for prevention of child physical abuse and future directions for research are discussed.     

Iranian Psychotherapists’ Behaviors and Beliefs Toward Sexual Orientation and Gender Identity

The aim of this study is to investigate Iranian psychotherapists’ behaviors and beliefs toward sexual orientation and gender identity. The sample consisted of 358 Iranian psychotherapists, of whom 29.3% (n = 105) were male and 67% (n = 24) were female. Results from the chi-square analyses showed that more male participants reported accepting homosexual clients and treating them as having a pathological disorder than their female counterparts; and licensed respondents reported engaging more in accepting only male or female clients, accepting more homosexual and transgender clients for treatment, and treating them as having a pathological disorder when compared with their unlicensed counterparts. Furthermore supervised respondents reported accepting more homosexual clients than their unsupervised counterparts. However results from the multivariate analysis of variance has indicated that the female participants reported “accepting homosexuals or transgender clients for treatment” more often than the male participants; unsupervised participants reported “accepting homosexual or transgender clients for treatment” and “treating homosexuality per se as a pathological disorder” more often than their supervised counterparts.     

Little girls and sex: A glimpse at the world of the “baby pro”

The literature on child prostitution is limited. There is some historical documentation, but data on contemporary empirical observations is generally unavailable. Moreover, most studies have focused on teenagers rather than on children. Drug abuse was the original concern of this investigation. During the course of the research, nine girls between the ages of 8 and 12 were encountered who admitted involvement in prostitution and/or pornography. They were not runaways. Rather, they had been introduced to their careers by relatives. Their initiation into sex seemed to be motivated by fear of rejection, their drug involvement did not appear to be associated with their sexual activities, and they did not seem to be traumatized by their early association with sex.     

Reports of recovered memories of childhood abuse in therapy in France

ABSTRACT

Recovered memories of abuse in therapy are especially controversial if the clients were not aware they were abused before therapy. In the past, such memory recovery has led to legal action, as well as a debate about whether such memories might be repressed, forgotten, or false memories. More than two decades after the height of the controversy, it is unclear to what degree such memories are still recovered today, and to what extent it occurs in France. In our French survey of 1312 participants (M_age?=?33; 53% female), 551 reported having done therapy at some point. Of that 551, 33 (6%) indicated they had recovered memories of abuse in therapy that they did not know about before therapy. Sexual abuse was the most commonly reported type that was recovered in therapy (79%). As in past research, discussing the possibility of repressed memories with therapists was associated with reports of recovered memories of abuse. Surprisingly, memory recovery occurred just as much in behavioural and cognitive therapies as it did in therapies focused on trauma. We found recovered memories in a proportion of clients who began therapy recently. Recovered memories in therapy appears to be an ongoing concern in France.     

My Love,How I Wish You Were By My Side: Maintaining Intercontinental Long-Distance Relationships in Taiwan

The purpose of this qualitative research was to explore how couples in Taiwan maintain intercontinental long-distance relationships. Four participants from a long-distance online forum were interviewed and asked to share their stories of long-distance dating. Their stories were then analyzed based on a narrative research method, and the following questions were explored with the participants: the impact of distance on the relationship, maintaining long-distance relationships, and reflections on long-distance dating. Findings suggested that distance had a large impact on couples, including thoughts of ending the relationship, loneliness, insecurity, and distrust. Themes the participants discussed included the importance of technology, face-to-face visitations, commitment, romantic beliefs, and diverse ways to maintain relationships. Participants also reported high expenses, time differences, and technological limitations as difficulties. Despite these difficulties, participants described creating meanings around the long-distance relationships by realizing the relationships were ultimately worthwhile, and for many couples, a necessary process to grow. Based on the results, the researcher proposes that therapists use narrative therapy in order to work with couples in long-distance relationships. By helping clients externalize the problem through opening up new possibilities for them to describe their difficulties, clients can begin to develop new ways of understanding themselves and others. A discussion with regards to how individuals in Chinese cultures manage conflicts in romantic relationships is included to remind therapists to be culturally sensitive when managing conflicts in collectivistic cultures, which have a tendency towards indirectness, unassertiveness, and lack of confrontation.     

Teacher reported types of sexual abuse of learners with intellectual disability in a South African school setting

This study investigated prevalent types of sexual abuse of learners with intellectual disability, as reported by teachers. Participants were 28 teachers from special educational needs schools in Gauteng Province, South Africa (females = 80%, age range = 30 to 55 years). The teachers participated in a focus group discussion on prevalent types of sexual abuse they were aware of that occurred to learners with intellectual disabilities. Thematic analysis of the data suggested five forms of sexual abuse of learners with intellectual disability: incest, rape by the members of the community, sexual harassment, child prostitution, and exposure to adult sexual encounters. Future research should focus on the ways to mitigate in-school sexual abuse of learners with intellectual disability; prioritising which forms of interventions would be effected.     

Relationships Between Treatment Components, Client-Level Factors, and Positive Treatment Outcomes

How different amounts and components of treatment affect substance abuse treatment outcomes is fundamentally important to evaluating current treatment practices and recommending improvements. Through a secondary analysis of data from the National Treatment Improvement Evaluation Study (NTIES), the present study examined the relationships between treatment components, client-level factors, and positive treatment outcomes. Several components were shown tohave significant effects on the odds of a positive outcome, over and above the effects of client background characteristics. Depending on treatment modality, these included length of stay; whether or not clients reported seeing their treatment plan hours per month in group and individual counseling; utilization ofeducational, vocational, and other ancillary services; use of antianxiety and drug and alcohol medications; and client matching. Several interactions between client-level factors and treatment components were also observed. Studylimitations are discussed, followed by implications for policy and practiceand suggestions for further research.     

A multi-site comparison of supported housing for chronically homeless adults: "Housing first" versus "residential treatment first"

Both direct placement in supported community housing and pre-treatment with time-limited residential treatment are used as approaches to helping chronically homeless adults exit from homelessness but relative effectiveness and cost remains untested. The current observational study utilized data from a national, multi-site housing project to determine whether clients who receive residential treatment or transitional housing before being placed into independent housing achieve superior outcomes than clients who are immediately placed into independent housing, and whether they incur greater healthcare costs. A total of 709 participants (131 and 578 participants in the respective groups) were assessed every 3 months for 2 years on housing outcomes, community adjustment, work and income, mental and physical health, and health service costs. Clients who received immediate, independent housing had more days in their own place, less days incarcerated, and reported having more choice over treatment; but no differences on other clinical or community adjustment outcomes. In this observational study, there were no clinical advantages for clients who had residential treatment or transitional housing prior to entry into community housing, but they incurred higher substance abuse service costs. Studies using randomized controlled trials of these conditions are needed to establish causation.     

Demands for Privacy Among Adolescents in Multimodal Alcohol and Other Drug Abuse Treatment

Adolescent clients' perceptions of the limits of confidentiality, as well as their privacy demands within the counseling relationship, were assessed. A total of 30 adolescents involved in individual, group, and family counseling for alcohol and other drug abuse served as participants. Participants were asked to respond to vignettes of confidentiality issues in terms of what they believed the counselor should do and what they would prefer the counselor to do. Results suggested that adolescents generally want higher levels of confidentiality than they expect to receive. This group of adolescent clients, however, made clear distinctions in their privacy expectations and demands according to specific situations.     

An examination of risky sexual behavior and HIV in victims of child abuse and neglect: a 30-year follow-up.

OBJECTIVE: This article examined links between childhood maltreatment and risky sexual behavior (early sexual contact, promiscuity, prostitution) and HIV in adulthood. DESIGN: Using a prospective cohort design, physically and sexually abused and neglected children (ages 0-11) with documented cases during 1967-1971 were matched with nonmaltreated children and followed into adulthood. MAIN OUTCOME MEASURES: Early sexual contact, promiscuity, and prostitution were assessed through in-person interviews and official records (prostitution) at approximate age 29 (N=1196). HIV tests were conducted at approximate age 41 (N=631). RESULTS: Child maltreatment was associated with prostitution (OR=2.47, 95% CI=1.35-4.50) and early sexual contact (OR=1.73, 95% CI=1.24-2.40). Prevalence of HIV in the abuse/neglect group was twice that in controls (OR=2.35, 95% CI=.64-8.62), although this difference did not reach conventional levels of statistical significance. SEM provided significant support for a model linking child abuse and neglect to prostitution through early sexual contact and a marginal link to HIV through prostitution. CONCLUSION: These findings provide prospective evidence that maltreated children are more likely to report sexual contact before age 15, engage in prostitution by young adulthood, and test positive for HIV in middle adulthood.     

Retrospective accounts of recurrent parental physical abuse as a predictor of adult laboratory‐induced aggression

Child abuse has been frequently associated with adult aggression in its many forms. The Point Subtraction Aggression Paradigm (PSAP) is a popular laboratory‐based procedure derived from the retaliatory responses of participants engaged in a monetary‐reinforced computer game. PSAP responses have been found to discriminate between participants with and without violent, antisocial, substance abuse, and even contact‐sport athletic histories. The present study provided an initial test of the sensitivity of the PSAP and the Overt Aggression Scale (OAS) in discriminating between college students (n=28) with and without reported histories of recurrent physical abuse as defined by incidents of being pushed, shoved, struck, punched, or threatened with physical violence by a parent more than once every six weeks over 15 years of upbringing. PSAP responses were substantially higher (d=2.1) among participants reporting histories of recurrent parental physical abuse, with 46% (as opposed to 0% for controls) of these individuals generating PSAP responses in excess of 400 (average found for violent parolees). Group differences on the OAS were also considerable (>1 SD). Larger factorial designs examining relationships between a range of developmental variables (e.g., domestic abuse, physical abuse, sexual abuse, parental divorce, family climate, etc.) and adult PSAP responding may help advance present knowledge regarding the impact of childhood adversity on psychological development. Aggr. Behav. 30:217–228, 2004. © 2004 Wiley‐Liss, Inc.