The child sexual abuse victim: Assessment and treatment issues and solutions

Particular attention is given in this paper to the assessment process with child sexual abuse victims and recommendations are made regarding practical issues both in the assessment and the treatment phases of therapeutic work with child victims.     

Self-centeredness and the adult male perpetrator of child sexual abuse

Self-centeredness has been identified as a quality of the adult male perpetrator of child sexual abuse, but little or no effort has been expended toward defining the concept clearly. In this paper, the research literature on the perpetrator and psychoanalytic writings on narcissism are reviewed for the purpose of developing a comprehensive definition of self-centeredness. Literature related to the social and developmental context of child sexual abuse also is discussed. In the final section of the paper, implications for primary prevention and treatment are drawn.This is a revised version of a paper presented at the Groves Conference on Marriage and the Family, July, 1986, in London, England. Support for the paper was provided through the Minnesota Agricultural Experiment Station and the Faculty Summer Research Fellowship Program, Graduate School, University of Minnesota.     

Elder abuse by family caregivers: Processes and intervention strategies

This study of 104 family caregivers who provided care to 119 elderly kin discusses the stress and conflict that can result when the older person, the caregivers, and the family are unprepared to fulfill the caregiving tasks. Sources of stress that contribute to physical and psychological abuse of the elderly are examined. Suggestions such as setting guidelines, establishing support groups, providing respite and household care, and increasing awareness about the aging process and elder abuse are offered as mechanisms for preventing abusive interactions and increasing the quality of life for the elderly and their families.Revision of a paper presented at the 1986 Groves Conference on Marriage and the Family, London, England.     

Using psychodynamic concepts in strategic family therapy: A suicidal adolescent case

This paper describes the treatment of a suicidal adolescent with strategic family therapy. The cotherapists conceptualized the case psychoanalytically and systemically. They propose that their understanding of psychodynamics enhanced their ability to tailor their interventions to the family's unique style and capacities. Rather than dismiss psychodynamic concepts as irrelevant to strategic family therapy, they maintain that an appreciation of individual members' ego strengths, defenses, affects, and unacknowledged impulses leads to the construction of more effective metaphors and a set of interventions more isomorphic to family patterns.     

GRADSCOPE: An Analysis of the Item Structure and a Survey of Usage

Two studies of GRADSCOPE, the most widely-used system for computer-assisted careers guidance in higher education in Britain, are reported. The first is an item analysis of the GRADSCOPE questionnaire. The six-factor solution from this factor analysis suggests that, with the exception of the Artistic theme, the content domain of the GRADSCOPE questionnaire covers Holland's occupational themes, and that GRADSCOPE is primarily concerned with the motivational component rather than the performance requirements of jobs. The second study, a postal survey of careers services and careers advisers about their experiences of using the interactive version of GRADSCOPE, aimed to examine the potential of interactive systems to effect change in careers work.     

Cultural tensions in strategic marital therapy

Whether the elements of a good marital relationship are universal is the question addressed in this case study of therapy with a couple who were culturally different from the therapist. The conflicts between the therapeutic strategies, which were based on a strategic therapy model, and the customs of the couple from a foreign culture, made it difficult to evaluate whether the therapist was on target with interventions. On one hand, therapists need to guard against being misled into believing that customs are cultural imperatives which never can be changed. On the other hand, they need to be aware of the impact and possible ramifications of challenging long-held, culturally-based beliefs and behaviors. The following case study details the dilemmas faced by a therapist working with an Asian-Indian couple who presented themselves as being bound by their cultural background and heritage.Grateful acknowledgement is made by the author to Etienne Phipps, PhD, whose comments give direction and substance to all my work.     

The conflict cycle in the case of an adolescent in crisis

This is an extension of a previous paper describing a conflict cycle in families and therapy consisting of four steps: (1) the dispute; (2) blaming; (3) shame, guilt, or denial; and (4) reparation, reconciliation, or retaliation. The focus is on a single case of a 15-year-old male with a gender identity disorder in addition to a conduct disorder. He is an adopted child living in a small community in the southern United States. Conflict is illustrated from several perspectives in a single interview with the family and over the length of contact over a nine-month period: (1) between the adolescent and parents, (2) between the adolescent and community, (3) between the parents, and (4) between the Good Self and the Bad Self of the adolescent. The thesis is that the conflict cycle is an organizing principle helpful to therapists working with families to make assessments and plan interventions.This paper is an expanded and edited version of a presentation by the senior author in San Diego, California, on November 12, 1988, at the Western States Conference of the American Society of Adolescent Psychiatry.     

Using a threat of divorce for maintaining family homeostasis within families in extreme distress (FED)

This paper describes a phenomenon of using a threat to divorce by families in extreme distress (FED) as a way of maintaining family homeostasis; that is, using a threat to divorce but never really implementing it. By relating to processes, such as social exchange and attachment, that often take place in the decision-making of divorce, we try to understand why those families choose to use the threat, thereby explaining this phenomenon. Using components of defining family boundaries, excitement and power struggle, we are thus able to better understand the existence of the phenomenon among FED.     

Stories and metaphors as interventions with headache sufferers

Stories and metaphors can serve as an effective intervention with chronic headache sufferers. Stories and metaphors can serve as an effective intervention with chronic headache sufferers. The aim of the intervention is to promote sufferers' self confidence, increased resiliency, improved communication with others in the family, and the identification of previous promises, pledges, or commitments made to others in their family system.