Sexual abuse intervention: a support group for parents who have a sexually abused child

A pilot program for parents of sexually abused children is discussed with a focus on intervention at a systems level. The Parent Support group is based on an eclectic approach and the interventions at the therapeutic and educational levels are described. The evolution of the group is addressed based on the group objectives. Each of the thirteen sessions is described to illustrate the various intervention strategies. Suggestions for implementing a similar group are discussed based on the authors' experience utilizing the presented model.     

Counselling in Action: Sexual abuse in an Asian family

This case study concerns a family of three generations of Asians living in London. It involves three children (two boys and a girl) who were sexually abused by one of the members of the extended family, for a period exceeding 5 years. Attempts to deal with the problem within the secrecy of the family conspiracy failed. It led to a breakdown of communications within the family network. Subsequently, the problem came under police investigation. The perpetrator was found guilty and sentenced to a term of imprisonment. Of the three young victims, the girl was extremely traumatized. Initially, she refused to meet with the therapist, but gradually, at the gentle persuasion of her parents, she relented. The case study is an account of the therapist's culturally relevant use of indigenous techniques to successfully deal with the trauma, thus helping in the rehabilitation of the victim.     

Gender identity and family relationships: Perspectives from incestuous fathers

The purpose of this study was to understand how incestuous fathers constructed their gender identities and family relationships and to determine how these perceptions were linked to incest. Analysis of intensive interviews with 20 incest offenders suggested that incest occurred in context of entitlement stemming from masculine gender constructions and family experiences which lead to conflicts regarding control and intimacy and a build up of failure. Case illustrations and implications for clinical practice are addressed.     

Recognition and treatment of incestuous families

Incest is a major mental health problem, in terms of both prevalence and morbidity. Father-daughter incest constitutes the majority of reported cases. The possibility of incest should be considered in a family which includes a violent father, a disabled mother, a child in an adult maternal role, or an acting out adolescent girl. Intervention requires recognition of the criminal and addictive aspects of the father's behavior. Active cooperation between mental health professionals and mandated child protective and law enforcement agencies is necessary for effective treatment. Group therapy and affiliated self-help programs appear to be the treatment modality of choice. Rehabilitation of the family is based upon restoration of the mother-daughter bond as a guarantee of safety for the child.     

Sequelae of child sexual abuse: a child and parent assessment

We present a case example of a 9-year-old, biracial girl and her mother. We integrate data collected from rating scales (e.g., Child Behavior Checklist; Achenbach & Rescorla, 2001), a free response measure (Thematic Apperception Test; Murray, 1943), and a direct observation measure (Parent-Child Interaction Assessment-II; Holigrocki, Kaminski, & Frieswyk, 1999, 2002) and reveal how a child sexual abuse victim's internal representations and symptoms manifest in both an interpersonal context and in the realm of play. We discuss assessment findings regarding how they provide for an idiographic understanding of the child.     

Family process in the treatment of intrafamilial child sexual abuse

The paper describes the changes in family dynamics that occur throughout the process of family-orientated treatment of families where father–daughter incest or stepfatherr–stepdaughter child sexual abuse has occurred. A detailed step-by-step analysis of the developing family process in incest families during therapy is given. The analysis establishes the nature of the original pattern of family relationships, explores the impact made by crisis intervention on the family structure and then outlines therapy and termination of treatment. Characteristic mechanisms in the family process during therapy are described. A detailed clinical example demonstrates the basic therapeutic moves and the mechanisms involved.     

child pornography and the internet: perpetuating a cycle of abuse

Thirteen men convicted of downloading child pornography were interviewed with a view to understanding how these men talked about the photographs and the function such talk played in their accounts. The interviews were informed by earlier work with defended subjects and were analyzed within a discursive framework. Quotations are used from the interviews to illustrate the analysis. Six principal discourses emerged within these accounts in relation to child pornography: sexual arousal; as collectibles; facilitating social relationships; as a way of avoiding real life; as therapy; and in relation to the Internet. These are discussed in the context of previous research. The analysis illustrates the important role that the Internet plays in increasing sexual arousal to child pornography and highlights individual differences in whether this serves as a substitute or as a blueprint for contact offenses. It also draws our attention to the important role that community plays in the Internet and how collecting facilitates the objectification of children and increases the likelihood that in the quest for new images children continue to be sexually abused. Discourses focussing on both therapy and addiction serve to distance the respondent from personal agency and allow for continued engagement with child pornography.     

Bereavement following the death of a child: Implications for family therapy

The death of a child, is perhaps one of the most excruciating events that a family could experience. Although much literature exists on the short-term effects of child death, little is written on the long-term family repercussions.This article briefly reviews the literature on bereavement, and then focuses on the effects of child death in the family. Issues of specific interest to the family therapist are highlighted.     

Memoirs of a drug-abusing prostitute: Dynamics and treatment considerations in a case of intergenerational child abuse

This paper examines the dynamics of a 26-year-old prostitute who entered psychotherapy with a number of symptoms. The patient had undergone a series of traumas in her life and was reenacting them in her present behavior. Repetition compulsion, as described by Freud, was a primary form of resistance manifested by this patient. The repetition of the sexual trauma reenacted itself in her choice of profession; namely, prostitution. Additionally, this woman had lived her early years falsely believing that her parents were caring for her, when in fact, they were her grandparents. This early family secret led to the development of a false self within the patient, as well as a strong sense of entitlement, greed, and need for revenge.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

Infants at risk for child abuse

Child abuse is most likely to occur when socially isolated parents react impulsively to aversive stimuli emitted by their children. Certain child signals and characteristics are aversive to adults. Infant cries are aversive to all parents, but children who are unusually irritable or whose cries are especially grating may become aversive to their parents even when they are not crying. Studies show that the cries of premature infants and the cries of babies incorrectly labelled premature are more aversive to parents, and that abusive mothers and the mothers of premature infants find cries more aversive than other mothers do. The incidence of abuse would be reduced by the availability of supportive social networks and the elimination of distorted parental expectations.     

Risk factors for child sexual abuse

We review the risk and protective factors for child sexual abuse. Overall, characteristics of perpetrators, victims, and families of victims were moderate to strong risk factors for child sexual abuse. However, it is difficult to distinguish between risk factors for extra-familial and intra-familial child sexual victimization because most of the studies combined these two types of child sexual abuse, although the risk factors for these two types of child sexual abuse most likely differ. Research in this area is difficult because etiological and prevention models of victimization would differ substantially from those of perpetration. Given the low yearly prevalence of child sexual victimization, very large samples would be necessary to obtain sufficient power. Thus, most studies have used lifetime prevalence, which may provide much useful information but which add substantial time confounds. Finally, child sexual victimization is probably a misnomer, as the nature, impact, and etiology of sexual victimization most likely differs over the large age span of childhood and gender. Because improved models and prevention programs require improved etiological models (based on knowledge of risk and protective factors), we hope that this review will focus stakeholders on the need for continued research in this area.     

Risk factors for child psychological abuse

We review the risk and protective factors for child emotional abuse. Two main directions can be derived from this review. First and foremost, definitional issues must be resolved. Second, some clues as to important future research directions emerged from the current risk factor literature. Distal historical variables (e.g., relationships with fathers perceived as less caring, and being yelled at daily as a child), current enduring personality factors (e.g., aggression and hostility, neuroticism), environmental stressors (e.g., very low income) and proximal variables (verbal and physical aggression between parents) all appear to be related to child psychological abuse. Once definitional issues are resolved, models beginning with these risk factors should be developed and tested.