Evaluation of a brief intervention for educating school children in awareness of physical and sexual abuse

The development and evaluation of procedures for imparting information to children regarding inappropriate treatment by adults is a challenging task that warrants increased methodological sophistication. The present study was conducted to evaluate proximal changes in fourth and fifth graders' knowledge and attitudes of physical and sexual abuse following brief skits and focal discussion in the classroom. The study used a control group of children that did not receive the intervention, which permitted a more accurate understanding of the program's effectiveness. Relative to controls, children who received the program showed an overall increase in knowledge of correct actions to take in the event of potential or actual abuse. Limitations of the study, as well as suggestions for broadening the scope and impact of child abuse prevention programs for children are discussed in relation to these findings.     

Child sexual abuse and incest: community-based intervention

OBJECTIVE: The primary aim of this article is to determine the effectiveness of community intervention in the case of child sexual abuse. The article describes and analyses an actual case in a small urban community in Israel. METHOD: After several incidents of child sexual abuse, much of it incestuous, were brought to light in the community, they were discussed openly, contained, and punished. A community campaign, in which community activists as well as all the service providers were involved, was organized by community social workers. Individual, group, and community interventions were used. RESULTS: The continuation of the abuse has been checked, and, so far, there is no evidence to suggest its resurgence. Community apathy to child sexual abuse seems to have been halted and reversed. The involvement of community residents, particularly the activists, has increased, and this appears to be the major factor in changed community norms toward child sexual abuse. CONCLUSION: Implications of the individual, group, and community interventions are discussed. An integrated program of intervention practices is advocated to contain and prevent the incidence of child sexual abuse and incest.     

A survey of intrafamilial sexual abuse treatment centers: Implications for intervention

This study was devised to determine the attitudes of treatment professionals regarding desirable therapeutic approaches for intervening in incestuous family systems. A survey of treatment centers currently providing services for the treatment of intrafamilial sexual abuse in the United States was undertaken. A questionnaire was developed to ascertain preferred methods and modalities of treatment of family sexual abuse. Current methods of treatment were identified and inquiries were made regarding what programs presently offer in terms of treatment. An inventory of 30 questions was mailed to 58 treatment professionals and/or treatment programs included in the study. A response rate of 62% was achieved. Treatment centers primarily offered treatment for family sexual abuse on an outpatient basis and staff composition was interdisciplinary in nature (psychology, nursing, marriage and family therapy, social work and psychiatry). An average of 137 cases of family sexual abuse were treated annually per treatment program, with the daughter or the stepdaughter being the family member most often sexually abused. Further findings were the following: (1) treatment programs stressed group treatment for offenders as the most effective therapeutic intervention, yet group treatment of offenders was not offered by treatment programs as frequently as other types of treatment; (2) an interdisciplinary team approach to treatment of incest cases was preferred, suggesting the need for more than one therapist working with each family sexual abuse case: (3) court intervention was seen as necessary to facilitating the treatment process by 79% of the 36 questionnaires returned; (4) family therapy was expressed as a preferred and essential component to the treatment process with incest cases—yet actual implementation of family therapy treatment was clearly not uniform across treatment programs; (5) the most critical finding of this survey is that there was a consensus among clinicians that there is no one sequence of treatment, and that it varies according to the specifics of each family. Regardless of theoretical orientation, the majority of respondents believe that a comprehensive family systems approach is advantageous to the goal of determining whether the family can and wants to rehabilitate itself.     

Child sexual abuse prevention: Evaluation of a teacher training model

Teachers are potentially helpful resource persons for large numbers of sexually abused children who may have difficulty disclosing abuse, particularly to family members. In the present study, the effectiveness of a 6-hour teacher training workshop on child sexual abuse prevention was evaluated. Responses of 26 female elementary teachers who participated in the workshop were compared to responses of 19 control teachers on several pre-, post-, and follow-up measures. Relative to controls, trained teachers demonstrated significant increases from pre- to post-testing in knowledge about child sexual abuse and pro-prevention opinions. On a post-only vignettes measure, trained teachers were better able than control teachers to identify behavioral indicators of abuse and suggest appropriate interventions for hypothetical sexually abused children. Over a 6-week follow-up period, trained teachers read more about child abuse than control teachers but did not differ on other behavioral dimensions such as reporting suspected abuse cases. Further research will examine the effects of additional teacher training over an extended follow-up period.     

Guilt, isolation and hopelessness among female survivors of childhood sexual abuse: effectiveness of group work intervention.

OBJECTIVE: This study explores the effects of group work intervention on female survivors' senses of guiltlessness, affiliation and hopefulness. METHOD: Secondary comparative analyses of a large quasi-experiment-based clinical data base were accomplished (Richter, Snider, & Gorey): group work intervention (N = 78) and a waiting-list condition (N = 80). RESULTS: Group work was found to have beneficial effects on adult female survivors' appropriate sense of guiltlessness for their childhood sexual abuse, as well as on their sense of affiliation and hopefulness. Consistent across the three outcome measures of guilt/guiltlessness, isolation/affiliation and hopelessness/hopefulness, 16 to 18 of every 20 such women who participated in group work did better than the average woman in the waiting-list comparison group. Moreover, these apparent clinical benefits were maintained for 6 months (all p < .01). CONCLUSION: Such effects may be characterized as very large, and are generally larger than those previously observed in this field of practice that have typically been based on more general measures of depression, self-esteem or global symptoms.     

The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women

The purpose of the present study was to explore the relationship of childhood sexual abuse with later psychological and sexual adjustment. Subjects were 383 female college students recruited from undergraduate psychology classes. Each was asked to complete a packet which contained a victimization questionnaire as well as measures of adjustment. A number of small, but significant, relationships were found between a history of childhood sexual abuse and measures of later psychological and sexual adjustment. In light of the relationship between family background and sexual abuse, however, it was questioned whether these associations were due to the sexual abuse per se, or were due to the confounding of sexual abuse with family background. Indeed, once parental supportiveness was controlled, very few significant relationships emerged. There was a trend, however, for the significant correlations to involve the sexual measures rather than the more general adjustment measures. The implications of the current findings, particularly for future research, were discussed.     

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women

OBJECTIVE: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. METHODS: Retrospective report from a random sample of 2,855 women aged 18-64 years old in two regions in New Zealand. Face-to-face interviews with one randomly selected woman from each household were conducted. RESULTS: The overall prevalence rates for CSA were 23.5% for women from the urban region and 28.2% from the rural region. In both urban and rural regions, Māori women more frequently reported experiences of CSA than women from European and other ethnic groups (urban: 30.5% vs. 17.0% and rural: 35.1% vs. 20.7%). The median age of onset of the abuse was 9 years, and the median estimated age of the abuser was 30 years. Half of those who experienced CSA reported that it occurred once or twice, 27% a few times, and 23% multiple times. Sole perpetrators were involved in 83% of cases. The majority of cases were perpetrated by a family member, most frequently male. Compared with non-victims, victims of CSA were twice as likely to experience later intimate partner violence and violence by others. CONCLUSIONS: This study reports on a large, population-based sample in an ethnically diverse population in New Zealand, providing the first ethnic-specific rates of CSA available. Findings suggest important priorities for prevention and intervention activities.     

Association between early sexual abuse and adult HIV-risky sexual behaviors among community-recruited women.

OBJECTIVE: The first purpose was to determine whether sexual abuse involving penetration that occurred in childhood only, adolescence only, or both childhood and adolescence differently impacted whether community-recruited women had ever traded sex for money or drugs, their number of recent sex partners, and the number of times they had engaged in recent unprotected sex. The second purpose was to assess the mediating effects of adulthood rape, recent drug use, and recent sex with an injection drug user on these three HIV-risky sexual behaviors. METHOD: Women (n = 1,490) recruited from three US sites were questioned about their childhood and/or adolescent sexual abuse histories, adulthood rape experiences, recent drug use, and adult HIV-risky sexual behaviors via structured interviews. RESULTS: One-third of the women reported having experienced sexual abuse involving penetration in childhood and/or adolescence. Overall, regression analyses indicated a significant relationship between early sexual abuse and adult risky behaviors; rape in adulthood mediated this relationship for all three HIV-risky behaviors. Abuse that occurred in childhood only and abuse that occurred in both childhood and adolescence had a stronger impact on later risky behaviors than did abuse that occurred in adolescence only. CONCLUSIONS: Because childhood constitutes a critical period in individuals' sexual, social, and personal development, sexual abuse precipitated during this time may distort women's constructions of sex and sexuality. Women abused in childhood may therefore engage in HIV-risky sexual behaviors to a greater extent than women abused in adolescence as a result of these disruptions to their development. Rape in adulthood appears to intensify the effects of early sexual abuse,     

Evaluation of a school-based sexual abuse prevention program: Cognitive and emotional effects

This study evaluated a school-based child sexual abuse prevention program which consisted of separate 2-hour workshops for children, parents, and teachers. Questionnaires concerning the children's knowledge about sexual abuse prevention and level of emotional distress were developed and administered to 88 children, ages 5-12, and 60 parents before and after the program. In addition, 12 teachers completed questionnaires about the children's level of emotional distress within 2 weeks after the program. Comparison of the children's knowledge before and after the program showed significant increases in knowledge about strategies for coping with potential abuse situations. Also individual children's responses were compared with their parents' responses. After the program the parents had a more accurate appraisal of their children's knowledge, and in addition, there was a significant increase in how much parents reported that they had talked with their children about sexual abuse. In terms of possible adverse emotional effects of the program, neither teachers nor parents noticed signs of increased emotional distress. In addition, the children reported that the program made them feel safer and better able to protect themselves. The findings support the value of providing sexual abuse prevention programs to children.     

Childhood physical and sexual abuse as risk factors for heavy drinking among African-American women: a prospective study

OBJECTIVE: This study examines the associations among characteristics of child sexual abuse. childhood physical abuse, lack of parental care, and heavy drinking in a relatively young, urban population of African-American women all of whom have documented histories of child sexual abuse. METHODOLOGY: The sample consists of 113 African American child victims who were brought to a city hospital emergency room for treatment and collection of forensic evidence in the 1970s and re-interviewed as adults in the 1990s. RESULTS: The results of this research suggest that multiple incidents of child sexual abuse, more than the characteristics of such abuse is an important predictor of adult heavy alcohol use and binge drinking. These results remain even after controlling for the effects of parental drinking behavior. CONCLUSION: Although the victim of multiple child sexual assaults is more likely to suffer force and penetration, these analyses suggest that it is the multiple victimization and not the force or penetration that drives the relationship between child sexual assault and drinking behaviors.     

Laughing to sexual education: feminist pedagogy of laughter as a model for holistic sex-education

This paper describes and analyses the ‘feminist pedagogy of laughter’ deployed in an original sex education presentation for college students, entitled Sexual Pleasure, Health, and Safety (SPHS). This work seeks to advance scholarship on liberatory education and humour in education by emphasising how we can use laughter to casually and joyfully deconstruct sexism, racism and heterosexism as they concern sexual stigma, violence, health and pleasure. This style of pedagogy also defuses discomfort around stigmatised topics and identities, disrupts oppressive norms about sex and bodies, and builds communities that enhance learning. We position the feminist pedagogy of laughter as a technique that may be replicated to empower participants to pursue sexual pleasure and wellbeing despite sexist, racist and heterosexist obstacles. Educators may apply the feminist pedagogy of laughter to create sex education lessons and curricula that participants can enjoy, learn from and apply in real life. The pedagogy may be especially useful in supporting high-impact lessons within the time constraints of university life.     

The diagnostic utility of sexual behavior problems in diagnosing sexual abuse in a forensic child abuse evaluation clinic

OBJECTIVE: This study examined the utility of sexual behavior problems as a diagnostic indicator of sexual abuse. The hypothesis was that sexual behavior problems are multiply determined and consequently are variably related to sexual abuse in a clinical sample. METHOD: A sample of 247 children evaluated for sexual abuse at a multidisciplinary forensic child abuse evaluation clinic were included. Results from the Child Behavior Checklist (CBCL) and the Child Sexual Behavior Inventory (CSBI) were analyzed and compared to the results of a structured abuse assessment performed independent of these scores. RESULTS: The forensic team assessment found evidence of sexual abuse in 25% of cases, and no evidence in 61%. Children in this sample exhibited an elevated level of both sexual and nonsexual behavior problems. However, considerable variability was noted in sexual behavior problem scores. Thus, in this study a high score or a low score had no relationship to the diagnosis of sexual abuse. Indeed, nonsexually abused children were just as likely to have high CSBI scores as sexually abused children. CONCLUSIONS: This study found no significant relationship between a diagnosis of sexual abuse and the presence or absence of sexual behavior problems in a sample of children referred for sexual abuse evaluation. The finding suggests that community professionals should use caution in relying on sexual behavior problems as a diagnostic indicator of abuse.     

The impact of child sexual abuse and stigma on methods of coping with sexual assault among undergraduate women.

OBJECTIVE: The aim of the current study was to determine whether a prior history of child sexual abuse increased the likelihood of using disengagement methods of coping with a sexual assault that had occurred within the past year. Once this was established, a mediational model was tested in which it was hypothesized that specific traumagenic dynamics and changed world views would mediate the association between child and/or adolescent sexual abuse and increased use of disengagement coping methods in response to a recent sexual assault. METHOD: One thousand and fifty women undergraduates from a New England state university completed a survey for research credit. Respondents were asked detailed questions regarding experiences of sexual assault within the past year, histories of child and/or adolescent sexual abuse, traumagenic dynamics, and world assumptions. Analyses were based on 106 participants who had experienced a sexual assault within the past year. RESULTS: Sexually assaulted young women with a history of child sexual abuse used more disengagement methods of coping to deal with the adult sexual assault than women without this history. In addition, the relationship between prior sexual abuse and the use of disengagement coping strategies was mediated by feelings of stigma, but not by feelings of betrayal and powerlessness or beliefs in the meaningfulness and benevolence of the world. CONCLUSIONS: This is the first study to find that sexually revictimized young women may be particularly at-risk of relying on disengagement methods of coping with sexual assault. Furthermore, this association is mediated by feelings of shame or stigma. Directions for further research and clinical implications are discussed.