Time limited group therapy for female adolescent survivors of child sexual abuse

The impact of sexual abuse can be devastating, especially for young girls at the crucial stage of adolescent development. Ramifications for these survivors of sexual abuse are addressed. This paper describes the effectiveness of group therapy as a means of intervention. Group considerations discussed include group name, member and leadership selection, methods of evaluation, confidentiality and objectives. Our programme aimed to empower teenage survivors and strengthen their coping mechanisms and this paper will describe the theoretical background to the work, the rationale for using a group work approach, the processes involved and highlight the evaluations both concurrent and retrospective.     

The obligation of health care professionals and supervisors to report child sexual abuse

Child sexual abuse is a problem that often can be stopped or prevented if reported. This article summarizes child sexual abuse: its incidence, signs and symptoms. and legal and ethical issues. Through a case study, a five-step approach to the reporting of child sexual abuse is presented to help health care professionals and supervisors in fulfilling their ethical and legal obligations.     

Enhancing the health care experiences of adult female survivors of childhood sexual abuse

This article addresses the medical issues presented by women who were sexually abused in childhood and provides a detailed and direct link between the existing literature and its implications for the medical system. A profile of the sexual abuse survivor is given, including child sexual abuse (CSA) characteristics and sequelae that influence the adult female survivor's health. Post-traumatic Stress Disorder is outlined as part of a complex interplay of physiological and psychological symptomatology that can compromise the CSA survivor's ability to access health care treatment and forge a positive provider/patient relationship. This article emphasizes that effective treatment with sexual abuse survivors must include interdisciplinary collaboration among health care professionals. Management of the CSA patient, a case vignette illustrating salient themes, and finally, guidelines for the health care practitioner are presented.     

Working with perpetrators of child sexual abuse: Issues for social work practice

Research was funded by an award from the Social Work Services Group of the Scottish Office.     

Primary health care for adult survivors of childhood sexual abuse

Abstract: Increasing numbers of adults have been seeking help for childhood sexual abuse in recent years. Dearth of services led to the formation of a resource network from a range of health and welfare services in an inner region of Melbourne. Information gathered through the network indicates that adult survivors presented to primary health agencies in distinct ways. Some sought help primarily for sexual abuse, while others sought help for physical or emotional problems, with sexual abuse remaining masked. Yet others were prevalent in welfare settings, such as women's refuges. Generalist workers in such settings had varied levels of expertise in providing adequate help. When seeking to refer their patients because of concerns about suicide, they found appropriate referral difficult. Public sector mental health workers did not readily undertake work in childhood sexual abuse, and medical practitioners were relatively unaware about the relevance of childhood sexual abuse to physical and emotional ill-health.     

Partnership in practice: what parents of a disabled child want from a generic health professional in Australia

Despite the love that exists between children with disabilities and their parents and the positive contribution that children with a disability make to families and communities, caring for a child with a disability can be difficult and demanding for parents, carers and the family. Their interaction with the many and varied health professionals they encounter can serve to either ameliorate or exacerbate these difficulties. In this paper we report on a qualitative needs analysis undertaken as part of a project to develop disability awareness resources for generic health professionals (GHP). Data were collected through focus groups (n = 5) and individual interviews (n = 7) with 34 parents/carers and was analysed using a process of thematic analysis. ‘Partnership’ was identified as the overarching theme that answers the question ‘What do parents/carers want from a GHP?’ Three further themes were identified that together tell the partnership ‘story’. These are: ‘The GHP–parent partnership’, ‘Qualities of a GHP’, and ‘The role of advocacy in the GHP‐parent partnership’. Implications are presented that highlight the importance of advocacy in GHP–parent partnerships and suggest improvements in GHP education and preparation.     

Group work with female survivors of childhood sexual abuse: Evidence of poorer outcomes among those with eating disorders

ObjectiveThis study explored levels of depression and self-esteem after childhood sexual abuse (CSA) group treatment for survivors with and without histories of eating disorders (ED).MethodsFifty adult female survivors completed a 15-week CSA group treatment program and were assessed at intake, pre-group treatment, discharge, and six months follow-up using the Beck Depression Inventory, the Generalized Contentment Scale and the Index of Self-Esteem. They were also asked to report on their CSA histories and comorbid psychiatric issues including histories of ED.ResultsSurvivors with reported histories of anorexia nervosa or bulimia nervosa were significantly more depressed (minimum p < .05) and tended to have significantly less self-esteem (minimum p < .10) at discharge and six-month follow-up than those without ED. The size of these effects suggested their potential clinical significance as well. Seven to nine of every ten clients with histories of ED were more depressed and had lower self-esteem than the typical client without ED at discharge and at six-month follow-up.ConclusionThe findings suggest that CSA treatment programs should assess survivors for ED as they might benefit from a more specialized focus on their emotional responses to the abuse.     

'I want to do what I want to do': Young adults resisting sexual identities

Sexual identities lie at the heart of social and public health writings about sexual health risk and, as such, are often subject to uncritical assumption and imposition. In this paper, a critique is offered of such discourses along with the equation that sexual identity can predict the nature of practice within and outside the bedroom. In doing so, the authors draw on the findings of two recent independent yet conterminous Australian qualitative studies of sexual identities and practices to examine how young women's and men's identities resist occupying stable, predictable and causal relationships to sexual practices. Finally, the implications of such empirical findings for HIV/AIDS and STI prevention activities are explored.     

Working with preschool-aged child abuse victims in group settings

This paper will describe characteristics of child abuse victims and how the adult can best meet the victim's special needs in a group setting. Appropriate techniques to use to facilitate communication, to define appropriate behavior, to stimulate language, and to encourage skill development will be discussed. The appropriate staff training, support, and child-staff ratio will be included.     

Psychophysiological sexual arousal in women with a history of child sexual abuse

On the basis of literature that suggests that child sexual abuse (CSA) survivors with post traumatic stress disorder (PTSD) have higher baseline sympathetic nervous system (SNS) activity than healthy controls and research that suggests that the SNS plays a critical role in female physiological sexual arousal, we examined the impact of SNS activation through intense exercise on sexual arousal in women with CSA and PTSD. We measured physiological and subjective sexual arousal in women with CSA (n = 8), women with CSA and PTSD (n = 10), and healthy controls (n = 10) during exposure to nonerotic and erotic videos. After exercise, women with CSA and women with CSA and PTSD showed no significant differences in the physiological sexual response compared with no exercise, which was different from the increased physiological sexual response after exercise observed in control women.     

Child sexual abuse treatment: misinterpretation and mismanagement of child sexual behavior

OBJECTIVE: The purpose of the study was to examine caregiver understanding of the impact of child sexual abuse and the management of abused children in residential treatment. METHODS: A purposive sample of 20 registered nurses and child care workers were interviewed about their experiences working in residential treatment and their knowledge about child development and child sexual abuse and its application to practice. Data from interviews and field notes were analysed using dimensional analysis. FINDINGS: Caregivers had limited knowledge of the sequelae of child sexual abuse. Developmentally appropriate behaviour of sexually abused children, as well as behavioural manifestations of child sexual abuse, were often misinterpreted and mismanaged. CONCLUSION: Residential care of sexually abused children should be based on sound developmental principles and caregiver sensitivity.     

What allied health professionals want from continuing education programs: a study of five disciplines

The purpose of this study was to determine what allied health professionals want from continuing education programs. Both the content desired and the format of such programs were investigated. The results from five allied health disciplines are reported, including: Medical Dietetics, Medical Technology, Occupational Therapy, Physical Therapy and Radiologic Technology.