Me and My Shadow: Therapy with Sexually Abused Pre-Adolescents

The purpose of this paper is to describe the use of solution focused techniques with preadolescent children who have been sexually abused and to present a therapeutic model that: 1) represents a blending of traditional psychological theoretical ideas with the more recent solution focused techniques; 2) presents a unique time-limited group format for assisting children to come to know and like their authentic selves; and 3) provides the therapist with the opportunity to expand his or her roles. In this model, the path from false self to authentic self is conceptualized as an interplay among abuse events, family relationships, and other life contexts.     

The Development,Process, and Evaluation of Group Psychotherapy With Sexually Abused Preschool Girls

The development, process, and evolution of group psychotherapy specifically designed for sexually abused preschool aged females is presented. Utilization of male and female cotherapists, group structure, individual and family dynamics, the role of children's mothers in treatment, and process of treatment are examined. Issues regarding countertransference phenomena, cotherapy relations, in-depth involvement of the children's mothers, and specifics related to structuring of a time-limited group are beyond the initial intent and scope of this paper, and are not discussed here.

The cotherapists conclude that group psychotherapy for children of this age group is both clearly valuable and highly indicated as an adjunct treatment modality. In future group psychotherapy with sexually abused preschool aged children, based upon clinical experience and evaluation, the cotherapists advocate a time-limited approach whereby each session would focus upon specific issues as illustrated in Table 1, and include structured and purposeful involvement of the girls' caretakers.     

Group Treatment of Sexually Abused Adolescent Girls: A Review of Outcome Studies

Abstract

This paper considers factors that make children “at risk” for postdivorce maladjustment. The risk factors include (a) demographic variables of sex, age and socioeconomic status; (b) predivorce family functioning; (c) postdivorce relationship with the ex-spouse; (d) postdivorce parentchild interaction; and (e) social support systems. Treatment programs incorporating these factors are briefly described. Recommendations are provided for the clinician and researcher.     

Equine Facilitated Therapy with Children and Adolescents Who Have Been Sexually Abused: A Program Evaluation Study

Child sexual abuse (CSA) is a social problem that often inflicts long lasting psychological trauma and leads to psychopathology, behavioural problems and re-victimization. Treating young people who are presenting with the detrimental effects of CSA is often difficult because these effects off-set efforts at establishing a therapeutic bond. Animals have been found to facilitate the development of the therapeutic alliance between client and practitioner and therapies utilizing horses have the added bonus of empowering clients. This study aimed to evaluate an Equine Facilitated Program (EFT) run by Phoenix House, a sexual assault referral centre in Queensland, Australia. Participants were six boys and nine girls (aged 8–11 years) and 15 adolescent girls (aged 12–17 years). All participants provided several measures of data designed to establish levels of psychological distress at three points in time. That is, Time 1—intake into the service; Time 2—following approximately 6 weeks of in-clinic counselling and pre-EFT; and Time 3 post-EFT (9–10 week duration). Significant improvements in functioning were found between Time 2 and Time 3 assessment across all psychometric measures and for both age groups. No, or non-significant, improvements were found between Time 1 and Time 2 assessments. Overall the results show that EFT proved an effective therapeutic approach for the children and adolescents referred to the service. Of particular note was the finding that efficacy was similar across gender, age and Indigenous/non-Indigenous status. Implications of this and suggestions for further research are discussed.     

The Fear of Turning into Dust: Notes on a Group for Sexually Abused Women

For 10 years, I have been responsible for a group for adults who were sexually abused during childhood. In this brief paper, I will analyze one aspect of the particular kind of identification that exists between a child and an abusing adult, using Bion's concept of valency and Kaes' theories of unconscious alliances and pacts, in an attempt to further qualify Ferenczi's concept of identification with the aggressor. I will then show how the group encourages the process of disidentification with the aggressor.     

Group Therapy, Spiritual Issues, and Vietnam Veterans

This article describes a form of therapy that focuses on the spiritual dimension of the experience of American military veterans. Since definitions of spirituality abound, it is important that therapists be able to work with multiple understandings of spirituality simultaneously. Such veterans often resist facing, much less integrating, the spiritual dimension of their experience in therapy. A process is described that uses a VA Chaplain as a co-therapist on a monthly basis in an ongoing group. Telling Biblical stories and parables, in the context of therapy, is reported as a valuable means to enable clients to deal with their spiritual issues.     

The Interface Between Countertransference and Projective Identification in a Case Presented to Peer Supervision

This case report, presented to a supervision group, is a prenatal genetic counseling casethat caused me a great deal of emotional discomfort as the events unfolded. Thediscomfort originated during my first meeting with the couple for routine preamniocentesiscounseling and continued through later encounters. This case illustrates the process ofworking through countertransference and projective identification issues that may arise ingenetic counseling.     

Experience in Developing a Combined Activity and Verbal Group Therapy Program with Latency-Age Boys

Ten fundamental principles are outlined for the practice of brief, dynamic group therapy within a 10- to 20-session time limit. They include: group composition and screening; contracting for appropriate goals: facilitating rapid cohesiveness; stages of group development; building a work group atmosphere; leadership style; structural levels of focus; transference and countertransference considerations; the cotherapy relationship; and curative factors. This approach integrates recent formulations from the practice of short-term individual therapies as well as brief group approaches. Each brief group principle is contrasted with its long-term analytic group counterpart. Relevant research literature, historical roots, as well as other types of brief therapy groups are reviewed. The recent and experimental nature of these techniques is critically discussed.     

Projection,Introjection, and Projective Identification: A Reformulation

In this essay, the author recommends a reformulation of the psychoanalytic concept of pojection. The author proposes that projective processes are not merely defensive maneuvers that interfere with perception, but rather an essential means by which human perception is rendered possible. It is the manner in which human beings test and-evaluate reality in terms of their experiential structure, and their needs for survival and nourishment. Projection is the early phase of introjection.     

Medicating Patients in Psychoanalytic Therapy: Implications for Introjection,Transference, and Countertransference

If a patient comes for psychotherapy or psychoanalysis, why medicate him with psychotropic drugs? The answers to this question are explored and addressed from several points of view. The central hypothesis of this paper suggests that most of the reasons for medicating patients have to do with therapist's unresolved countertransference issues. Furthermore, medicating a patient may have deleterious effects on his introjected sense of self, and impacts the transference relationship in a significant way. The issues surrounding medication as adjunctive therapy are elucidated and clarified in terms of rationale, efficacy, and the impact on the psychotherapeutic relationship. Psychoanalytic solutions are offered and discussed.     

Counselor Trainees' Self-Statement Responses to Sexually and Physically Abused Clients,and Client Role Conflict

Because sexual abuse issues present a threat to counselor trainees, the authors predicted that trainees who expected to counsel a sexually abused client would respond with an increase in anxiety and negative self-statements. A total of 63 female trainees were assessed after viewing a videotape of a client reporting sexual abuse, physical abuse, or role conflict. Results indicated that, counter to predictions, the trainees who expected to counsel the sexually abused client increased their positive self-statements. Schwartz's (1986) States-of-Mind model was applied to the self-statement ratios, and, according to the model, trainees were unrealistically optimistic with respect to their counseling.     

Making of Victim a Patient: Sexually Abused Children and the Consequences of Unprofessional Help

The disclosure of sexual abuse by a child not only disturbs the mental peace of the family members but influences their attitudes towards the victim as well. This article explores how the diverse types of attitudes of the family members towards the victim and un-fulfillment of role expectation of a victim from his/her family members make him/her a patient. An attempt has also been made to analyse how the reluctance of parents to take any professional help impedes the recovery of the child along with the strategy a child adopts to cope with this traumatic event of his/her life. The child wants love and support from his/her close relatives, besides expecting protection from them. In such circumstances even a little negligence from any of the family members or their unsupportive and unpractical attitudes towards the victim, makes him/her a silent sufferer. A sense of helplessness develops in her/him and later on this sense of helplessness makes him/her a patient of depression.     

The Observant Jewish Victim of Spouse Abuse: Dynamics and Countertransference Issues

This article provides an overview of the dynamics of wife abuse, including its definition, the victim's tendency towards self blame, and the forces keeping her in the relationship. Socio-cultural and practical concerns relevant to the Orthodox victim are specifically examined. These include stigma of divorce, Rabbinic involvement, difficulties with obtaining the Get, and reluctance to seek shelter away from the community. Common countertransference issues that clinicians may struggle with when working with women who are abused are discussed, for example feeling pressured to save the marriage, frustration with resistance, and/or rescue fantasies. The article also offers implications for practice with this very complex population.     

Multidimensional Self-Perception of Sexually Abused Girls: Factor Models and Differences Between Sexual Abuse and Comparison Groups

This study investigated the multiple dimensions of self-perception in a sample of sexually abused and nonabused comparison girls (n = 140), with particular attention to self-perception in the scholastic, social, athletic, physical (appearance), and behavioral conduct domains. First, this study examined whether the five dimensions of self-perception were psychologically discrete. Second, the relationships between the self-perception factors and childhood sexual abuse were investigated using structural equation modeling. The results supported the multidimensionality of self-perception and suggested the presence of two distinct second-order self-perception factors: academic- and social-self. While the sexually abused girls indicated less positive perception for the academic-self than the comparison group, the two groups did not differ regarding the social-self. The findings highlight the importance of a multidimensional approach to self-perception in assessing and treating sexually abused children.     

Marriage and Family Therapy with Low-Income Clients: Professional,Ethical, and Clinical Issues

Economic stress greatly increases the likelihood of mental health issues occurring within a family. Although this is widely known within the mental health profession, there is a lack of literature that assists therapists in working effectively with low-income clients. As a result, marriage and family therapists may be ill equipped to meet the needs of those in poverty, and may even be conducting therapy that is ethically unsound. The authors of this article discuss several ethical and professional issues regarding therapy with families in poverty. A number of suggestions are presented for improving the effectiveness of therapy with low-income clients. Michele E. Grimes and Alyssa D. McElwain are masters students in Marriage and Family Therapy at Purdue University Calumet, Hammond, IN. Michele E. Grimes and Alyssa D. McElwain contributed equally to this article.     

Group Therapy Today: Styles,Methods, and Techniques

Abstract

This article describes the common resistance patterns that occur in ongoing cancer support groups. These resistances, which can often go unrecognized, are a normal part of group development and group life in such groups, rather than the result of a few “problem” group members. The thesis of this article posits that the identification and working through of these resistances creates openings to deeper engagement among members and to overall greater group cohesion. Technical guidelines are offered for working with these resistances in the group-as-a-whole, in members, and also in the therapist.