It takes two to tango: Research and practice as an amazing dance

This paper offers an appreciative critique of Kim Etherington's recent book, Narrative Approaches to Working with Adult Male Survivors of Male Child Sexual Abuse. I discuss the issues raised in the book with reference to one of my current clients. Etherington does not produce new substantive theory: the power of this work is in the narrative. Her important contribution lies in the reflexivity with which she encounters her material. The use of critical reflexivity challenges the subject/object dichotomy inherent in much positivistic research, and presents a much‐needed approach to process that is congruent with the lived experience of counselling. I would suggest that research is more likely to succeed in informing practice if the material is open to personal interpretation by the reader/therapist. Further, I would claim that the activity of using research creatively is itself a heuristic process: useful learning is most likely to occur if the dialogic relationship with the client and therapist is mirrored in the relationship between the therapist and the research text.     

Reduced right hemisphere activation in severely abused violent offenders during a working memory task: An fMRI study

This study uses functional magnetic resonance imaging (fMRI) to address two important gaps in our knowledge of brain functioning and violence: (1) What are the brain correlates of adults in the community who have suffered severe physical abuse early in life and who go on to perpetrate serious violence in adulthood? (2) What characterizes those who experience severe physical abuse but who refrain from serious violence? Four groups of participants recruited from the community (controls, severe physical child abuse only, serious violence only, and severely abused, seriously violent offenders) underwent fMRI while performing a visual/verbal working memory task. Violent offenders who had suffered severe child abuse show reduced right hemisphere functioning, particularly in the right temporal cortex. Abused individuals who refrain from serious violence showed relatively lower left, but higher right, activation of the superior temporal gyrus. Abused individuals, irrespective of violence status, showed reduced cortical activation during the working memory task, especially in the left hemisphere. Brain deficits were independent of IQ, history of head injury, task performance, cognitive strategy, and mental activity during the control task. Findings constitute the first fMRI study of brain dysfunction in violent offenders, and indicate that initial right hemisphere dysfunction, when combined with the effects of severe early physical abuse, predisposes to serious violence but that relatively good right hemisphere functioning protects against violence in physically abused children. Aggr. Behav. 27:111–129, 2001. © 2001 Wiley‐Liss, Inc.     

Kids and Teens in Court (KTIC): A Model for Preparing Child Witnesses for Court

Each year, numerous children testify in the United States in either criminal, civil, or juvenile court cases. Typically, children who testify are alleged victims of sexual or physical abuse or neglect, witnesses to violent crime, or subjects in custodial hearings in civil court. As more maltreatment cases are prosecuted and child custody is contested, an increasing number of children are being called as witnesses in court. Many of these children have already been traumatized by the experiences that led to their need to testify, and participation in the court process can have additional negative effects. This article describes the development and recent formative evaluation of a court preparation program that provides psychoeducation and utilizes components of evidence-based trauma treatment approaches, such as relaxation and in vivo exposure, to support child witnesses and reduce the risk of retraumatization. Children and adolescents participating in the program attend group sessions conducted by mental health clinicians and complete a court-related anxiety measure before and after each session. Results from 175 participants are reported. Findings indicated significant decreases in court-related anxiety with large program effects. Challenges encountered by the program and future directions are discussed.     

Factors associated with erection in adolescent sex offenders

A majority of adult child molesters report that their deviant interest began prior to the age of 18. This illustrates the need to evaluate adolescents who have molested children. Since self-report of deviant interest is rare in adolescent offenders, psychophysiologic assessment is necessary to help to determine the extent for a deviant interest pattern. The current study was designed to determine what factors are associated with erectile responding to age-inappropriate stimuli in an adolescent sex offender population. Factors studied were (a) admit/deny, (b) history of physical abuse, (c) history of sexual abuse, (d) history of nonsex arrests, and (e) incest/nonincest. The dependent variables were two pedophile indices, a relative measure of deviant to nondeviant arousal. Results indicated that history of sexual abuse was associated with more deviant erectile responding in those adolescents who had molested young boys. The possibility of adolescents modeling their own victimization is discussed.     

A developmental perspective on psychotherapy process, psychotherapists' expertise, and “Meaning-Making Conflict” within therapeutic relationships: A two-part series

Part I (in this issue)—A Dialectical-Constructivist View of Human Development, Psychotherapy, and the Dynamics of Meaning-Making Conflict Within Therapeutic Relationships— reviews a dialectical-constructivist model of human development and articulates, in the language of that model, how psychotherapy, in general, works. It describes and illustrates three generic processes, which contribute to the frequent successes of an extremely diverse range of psychotherapy theories and practices. This view of psychotherapy focuses on both the client's meaning-making processes and the therapist's meaning-making processes and how they contribute together to effective psychotherapy. Part I also offers a way of understanding what is going on when therapeutic progress is blocked by conflict between the client's and the therapist's meaning-making processes. Part II—Dialectical Thinking and Psychotherapeutic Expertise: Implications for Training Psychotherapists and Protecting Clients from Theoretical Abuse—explores those experiences in which the therapist's own exercise of his or her meaning-making structures, and maintenance of the integrity of his or her theories, has a limiting or destructive impact on the value of therapy to the client. It considers the concept of “theoretical abuse” by psychotherapists as a way of characterizing the most destructive of these experiences. This serves as a rhetorical device for introducing comparisons between these phenomena and the phenomena of sexual abuse by psychotherapists, in terms of dynamics, prevalence, and appropriate strategies for prevention. Part II uses work on the development of dialectical thinking in adulthood to conceptualize how different understandings of the nature of psychotherapists' expertise increase or decrease the likelihood and severity of “theoretical abuse”. Finally, it derives implications for training psychologists and other psychotherapy professionals.     

Prevention of Child Maltreatment: Evaluation of a Parent Education Program for Teen Mothers

We conducted an evaluation of a parent education program for the prevention of child maltreatment that served urban teen, unmarried mothers at risk for child maltreatment. Three to five years after the birth of their children, program graduates (n = 125) were significantly less likely than controls (n = 410) to have founded reports of maltreatment in the state database. On the basis of a follow-up phone call to a subset of 80 program graduates and 40 controls, mothers who enrolled in the 12-week parent education/support program showed trends toward being more likely to have completed high school, taken some college courses, and delayed subsequent pregnancies until after age 21.     

On advancing behavior analysis in the treatment and prevention of battering: Commentary on Myers

MYERS OFFERS AN IMPORTANT CHALLENGE TO BEHAVIOR ANALYSTS: eliminating the battering of women. In this commentary, we extend the conceptual model advocated by Myers, urge a bidirectional approach that focuses more on the battered woman and less on the battering man, caution against the indiscriminate use of marital therapy approaches, and argue that the most important contributions in the field may come from behavioral prevention rather than treatment interventions.     

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 credibility of sexual abuse allegations: Child sexual abuse, adult rape, and sexual harassment

Allegations and denials of sexual abuse often occur in a context in which there is rarely decisive evidence. The present study investigated the credibility of allegations of three kinds of sexual abuse—child sexual abuse, adult rape, and sexual harassment—that also contained a denial by the alleged perpetrator. Perceptions of fair punishment were investigated for the perpetrator if he did actually commit these acts and for the accuser if she was lying. Results indicated that allegations were generally rated in the credible direction. Allegations of child sexual abuse were rated more credible than allegations of rape or sexual harassment. Females found all allegations more credible than males. Males were more likely to believe allegations in the child sexual abuse condition than either the rape or sexual harassment conditions. Females were more likely to believe sexual harassment allegations. Punishments were generally the most severe for child sexual abuse, and psychotherapy was a popular disposition for both perpetrators and those making false allegations.     

The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients

The effect of 12-step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1-year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12-step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12-step involvement and friendship networks was tested using structural equation modeling, and found to have excellent fit to the data. Twelve-step group involvement after treatment predicted better general friendship characteristics (e.g., number of close friends) and substance abuse-specific friendship characteristics (e.g., proportion of friends who abstain from drugs and alcohol) at follow-up. Results are discussed in terms of how mutual help group involvement benefits patients and how the self-help group evaluation paradigm should be broadened.