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Treatment Issues in Child Sexual Abuse

Published online by Cambridge University Press:  02 January 2018

Danya Glaser
Danya Glaser*
Affiliation:
Department of Child Psychiatry, Bloomfield Clinic, Guy's Hospital, St Thomas Street, London SE1 9RT
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Abstract

Child sexual abuse is a commonly encountered and often emotionally damaging experience, maintained by secrecy and followed by denial after disclosure. Treatment in this field involves both the child and the family in a variety of treatment settings and modalities, often proceeding in parallel. Child developmental considerations dictate that treatment often proceeds in phases. It aims to protect the child from further abuse and the consequences of disclosure, and address the trauma and context of the abuse. Careful planning and co-operation is required by the many professionals working in this stressful area in order to avoid confusion, conflicts, and splits which may mirror relationships in the family. The heterogeneity of the problem is reflected in the fact that treatment cannot be offered in a uniform programme. Legal issues may influence the treatment process. Evaluation of treatment modalities, the identification of protective factors and achieving long-term adjustment in the least detrimental manner offer challenges in this newly developing field.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 159 , Issue 6 , December 1991 , pp. 769 - 782
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Abel, G., Becker, J. V., Murphy, W. D., et al (1981) Identifying dangerous child molesters. In Violent Behaviour: Social Learning Approaches to Prediction, Management and Treatment (ed. Stuart, R. B.). New York: Brunner Mazel.Google Scholar
Abel, G., Mittelman, M. & Becker, J. (1985) Sexual offenders: results of assessment and recommendations for treatment. In Clinical Criminology: The Assessment and Treatment of Criminal Behaviour (eds Benn-Aron, M. H., Huckle, S. J. & Webster, C. D.), pp. 191–205. Toronto: M. & M. Graphic.Google Scholar
Abel, G., Becker, J., Cunningham-Rathner, J., et al (1988) Multiple paraphiliac diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153–168.Google Scholar
Agosta, C. & Loring, M. (1988) Understanding and treating the adult retrospective victim of child sexual abuse. In Vulnerable Populations (ed. Sgroi, S. M.), pp. 115–135. Lexington, Mass.: Lexington Books.Google Scholar
Allen, C. (1990) Women as perpetrators of child sexual abuse: recognition barriers. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. J., Johnson, B. L., Roundy, L. M., et al), pp. 108 125. London: Sage.Google Scholar
Alter-Reid, K., Gibbs, M. S., Sigal, H., et al (1986) Sexual abuse of children: a review of the empirical findings. Clinical Psychology Review, 6, 249–266.Google Scholar
Arnold, R. P., Rogers, D. & Cook, D. A. G. (1990) Medical problems of adults who were sexually abused in childhood. British Medical Journal, 300, 705–708.Google Scholar
Ballard, D. T., Blair, G. D., Devereaux, S., et al (1990) A comparative profile of the incest perpetrator: background characteristics, abuse history and use of social skills. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. J., Johnson, B. L., Roundy, L. M., et al), pp. 43 64. London: Sage.Google Scholar
Bander, K. W., Fein, E. & Bishop, G. (1982) Evaluation of child-sexual-abuse programmes. In A Handbook of Clinical Intervention in Child Sexual Abuse (ed. Sgroi, S. M.), pp. 345–376. Lexington, Mass.: Lexington Books.Google Scholar
Becker, J., Cunningham-Rathner, J. & Kaplan, N. (1987) Adolescent sexual offenders: demographics, criminal and sexual histories and recommendations for reducing future offenses. Journal of Interpersonal Violence, 1, 431–445.Google Scholar
Bentovim, A. (1988) Understanding the phenomenon of sexual abuse – a family systems view of causation. In Child Sexual Abuse Within the Family: Assessment and Treatment (eds Bentovim, A., Elton, A., Hildebrand, J., et al), pp. 40 58. London: Wright.Google Scholar
Bentovim, A., van Elberg, A. & Boston, P. (1988) The results of treatment. In Child Sexual Abuse within the Family: Assessment and Treatment (eds Bentovim, A., Elton, A., Hildebrand, J., et al), pp. 252–268. London: Wright.Google Scholar
Berliner, L. & Ernst, E. (1984) Group work with pre-adolescent sexual assault victims. In Victims of Sexual Aggression: Treatment of Children, Women and Men (eds Stuart, I. R. & Greer, J. G.), pp. 105–126. New York: Van Nostrand & Reinhoki.Google Scholar
Bingley, L., Loader, P. & Kinston, W. (1984) Research report: further development of a format for family description. Australian Journal of Family Therapy, 5, 215–218.Google Scholar
Black, D., Wolkind, S. & Hendriks, J. H. (eds) (1991a) Child abuse and neglect. In Child Psychiatry and the Law (2nd edn), pp. 44–52. London: Gaskell.Google Scholar
Black, D., Wolkind, S., Hendriks, J. H. (eds) (1991b) Assessing parenting capacity. In Child Psychiatry and the Law (2nd edn), pp. 31–35. London: Gaskell.Google Scholar
Black, D., Wolkind, S., Hendriks, J. H. (eds) (1991c) Confidentiality. In Child Psychiatry and the Law (2nd edn), pp. 24–30. London: Gaskell.Google Scholar
Booth, W. (1890) A preventive home for unfallen girls when in danger. In In Darkest England and the Way Out. London: International Headquarters of the Salvation Army.Google Scholar
Boszormenyi-Nagy, I. (1985) Commentary: transgenerational solidarity – therapist's mandate and ethics. Family Process, 24, 454–456.Google Scholar
Briere, J. & Runtz, M. (1988) Post sexual abuse trauma. In Lasting Effects of Child Sexual Abuse (eds Wyatt, G. E. & Powell, G. J.), pp. 85–99. London: Sage.Google Scholar
Browne, A. & Finkelhor, D. (1986) Initial and long-term effects: a review of the research. In A Sourcebook on Child Sexual Abuse (eds Finkelhor, D., Araji, S., Baron, L., et at), pp. 143 179. London: Sage.Google Scholar
Budin, L. E. & Johnson, C. F. (1989) Sex abuse prevention programmes: offenders' attitudes about their efficacy. Child Abuse and Neglect, 13, 77–87.Google Scholar
Burgess, A. (1984) Response patterns in children and adolescents exploited through sex rings and pornography. American Journal of Psychiatry, 141, 656–662.Google Scholar
Carnes, P. J. (1990) Sexual addiction. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. J., Johnson, B. L., Roundy, L. M., et al), pp. 126 143. London: Sage.Google Scholar
Carr, A. (1989) Counter transference reactions to families where child abuse has occurred. Journal of Family Therapy, 11, 87–97.Google Scholar
Cicchetti, D. (1987) Developmental psychopathology in infancy: illustration from the study of maltreated youngsters. Journal of Consulting and Clinical Psychology, 55, 837–845.CrossRefGoogle Scholar
Conte, J. R. (1984) Progress in treating the sexual abuse of children. Social Work, 84, 258–263.Google Scholar
Conte, J. R. & Schuerman, J. R. (1987) Factors associated with an increased impact of child sexual abuse. Child Abuse and Neglect, 11, 201–211.Google Scholar
Coons, P. M. (1986) Child abuse and multiple personality disorder: review of the literature and suggestions for treatment. Child Abuse and Neglect, 10, 445–462.Google Scholar
Corder, B. F., Haizlip, T. & DeBoer, P. (1990) A pilot study for a structured, time-limited therapy group for sexually abused pre-adolescent children. Child Abuse and Neglect, 14, 243–251.Google Scholar
Damon, L. & Waterman, J. (1986) Parallel group treatment of children and their mothers. In Sexual Abuse of Young Children (eds MacFarlane, K., Waterman, J., et al), pp. 244 298. London: Holt Rinehart & Winston.Google Scholar
De Jong, A. R. (1988) Maternal responses to the sexual abuse of their children. Paediatrics, 81, 14–21.Google Scholar
Department of Health (1988) Working Together: A Guide to Arrangements for Inter-agency Co-operation for the Protection of Children from Abuse. London: HMSO.Google Scholar
Egeland, B., Jacobvitz, D. & Papatola, K. (1987) Intergenerational continuity of parental abuse. In Biosocial Aspects of Child Abuse (eds Lancaster, J. & Gelles, R.). New York: Jossey-Bass.Google Scholar
Elton, A. (1988a) Assessment of families for treatment. In Child Sexual Abuse Within the Family: Assessment and Treatment (eds Bentovim, A., Elton, A., Hildebrand, J., et al), pp. 153–181. London: Wright.Google Scholar
Elton, A. (1988b) Family treatment – treatment methods and techniques. In Child Sexual Abuse Within the Family: Assessment and Treatment (eds Bentovim, A., Elton, A., Hildebrand, J., et al), pp. 182–204. London: Wright.Google Scholar
Eth, S. & Pynoos, R. S. (1985) Post-Traumatic Stress Disorder in Children. Los Angeles: American Psychiatric Association.Google Scholar
Everson, M. D., Hunter, W. M., Runyon, D. K., et al (1989) Maternal support following disclosure of incest. American Journal of Orthopsychiatry, 59, 197–207.Google Scholar
Finkelhor, D. (1979) Sexually Victimised Children. New York: Free Press.Google Scholar
Finkelhor, D. (1988) The trauma of child sexual abuse: two models. In Lasting Effects of Child Sexual Abuse (eds Wyatt, G. E. & Powell, G. J.), pp. 61–82. London: Sage.Google Scholar
Finkelhor, D. & Baron, L. (1986) High-risk children. In A Source Book on Child Sexual Abuse (eds Finkelhor, D., Araji, S., Baron, L., et al), pp. 60 88. London: Sage.Google Scholar
Freud, A. (1982) A psychoanalyst's view of sexual abuse by parents. In Sexually Abused Children and Their Families (eds Mrazek, P. B. & Kempe, C. H.), pp. 33–34. Oxford: Pergamon.Google Scholar
Freud, S. (1896) The aetiology of hysteria. In The Standard Edition of the Complete Works of Sigmund Freud, Vol. 3 (ed. Strachey, J.), pp. 191–221. London: Hogarth Press and the Institute of Psychoanalysis.Google Scholar
Friedrich, W. N. (1988) Behaviour problems in sexually abused children: an adaptational perspective. In Lasting Effects of Child Sexual Abuse (eds Wyatt, G. E. & Powell, G. J.), pp. 171–191. London: Sage.Google Scholar
Friedrich, W. N., Berliner, L., Urquiza, A. J., et al (1988) Brief Diagnostic group treatment of sexually abused boys. Journal of Interpersonal Violence, 3, 331–343.Google Scholar
Frosh, S. (1987) Issues for men working with sexually abused children. British Journal of Psychotherapy, 3, 332–339.Google Scholar
Frosh, S. (1988) No man's land?: the role of men working with sexually abused children. British Journal of Guidance and Counselling, 16, 1–10.Google Scholar
Furniss, T. (1983a) Family process in the treatment of intrafamilial child sexual abuse. Journal of Family Therapy, 5, 263–278.Google Scholar
Furniss, T. (1983b) Mutual influence and interlocking professional-family process in the treatment of child sexual abuse and incest. Child Abuse and Neglect, 7, 207–223.Google Scholar
Furniss, T. (1989) Group therapy for boys. In Working with Sexually Abused Boys: An Introduction for Practitioners (eds Hollows, A. & Armstrong, H.), pp. 49–60. London: National Childrens' Bureau.Google Scholar
Furniss, T., Bingley-Miller, L. & Van Elburo, A. (1988) Goal-oriented group treatment for sexually abused adolescent girls. British Journal of Psychiatry, 152, 97–106.Google Scholar
Giaretto, H. A. (1982) Integrated Treatment of Child Sexual Abuse. Palo Alto: Science and Behaviour Books.Google Scholar
Gilgun, J. F. & Connor, T. N. (1990) Isolation and the adult male perpetrator of child sexual abuse: clinical concerns. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. J., Johnson, B. L., Roundy, L. M., et al), pp. 74–87. London: Sage.Google Scholar
Glaser, D. & Frosh, S. (1988a) Suspicion and disclosure: initial professional responses. In Child Sexual Abuse. London: Macmillan Education.Google Scholar
Glaser, D. & Frosh, S. (1988b) Therapeutic intervention. In Child Sexual Abuse, pp. 130–153. London: Macmillan Education.Google Scholar
Graham, P. (1986) Sexual abuse. In Child Psychiatry: A Developmental Approach. Oxford: Oxford University Press.Google Scholar
Groth, A. N. (1982) The incest offender. In Handbook of Clinical Intervention in Child Sexual Abuse (ed. Sgroi, S. M.), pp. 215–239. Lexington, Mass.: Lexington Books.Google Scholar
Groth, A. N. (1983) Treatment of the sexual offender in a correctional institution. In The Sexual Aggressor, Current Perspective on Treatment (eds Greer, J. G. & Stuart, I. R.). New York: Van Nostrand, Rein hold.Google Scholar
Hanks, H., Hobbs, C. & Wynne, J. (1988) Early signs and recognition of sexual abuse in the pre-school child. In Early Prediction and Prevention of Child Abuse (eds Browne, K., Davies, C. & Stratton, P.), pp. 138–160. Chichester: Wiley.Google Scholar
Hanks, H. & Stratton, P. (1988) Family perspectives on early sexual abuse. In Early Prediction and Prevention of Child Abuse (eds Browne, K., Davies, C. & Stratton, P.), pp. 245–266. Chichester: Wiley.Google Scholar
Haugaaro, J. J. & Reppucci, N. D. (1988a) Definitions of abuse. In The Sexual Abuse of Children. London: Jossey-Bass.Google Scholar
Haugaaro, J. J. & Reppucci, N. D. (1988b) Extent of the problem. In The Sexual Abuse of Children. London: Jossey-Bass.Google Scholar
Haugaaro, J. J. & Reppucci, N. D. (1988c) Family treatment. In The Sexual Abuse of Children. London: Jossey-Bass.Google Scholar
Haugaaro, J. J. & Reppucci, N. D. (1988d) Crisis intervention and treatment planning. In The Sexual Abuse of Children. London: Jossey-Bass.Google Scholar
Herman, J. (1981) Father Daughter Incest. Cambridge, Mass.: Harvard University Press.Google Scholar
Herman, J. (1983) Recognition and treatment in incestuous families. International Journal of Family Therapy, 5, 81–91.Google Scholar
Hildebrand, J. (1988) The use of group work in treating child sexual abuse. In Child Sexual Abuse Within the Family: Assessment and Treatment (eds Bentovim, A., Elton, A., Hildebrand, J., et al), pp. 205–237. London: Wright.Google Scholar
Hunter, M. (1986) The monster and the ballet dancer: a 4-year-old's view of sexual abuse. Journal of Child Psychotherapy, 12, 29–39.Google Scholar
Inquiry into Child Abuse in Cleveland (1988) Report of the Inquiry into Child Abuse in Cleveland 1987. London: HMSO.Google Scholar
James, B. & Nasjleti, M. (1983) Treating Sexually Abused Children and their Families. Palo Alto: Consulting Psychologists' Press.Google Scholar
Jones, D. P. H. (1986) Individual psychotherapy for the sexually abused child. Child Abuse and Neglect, 10, 377–385.Google Scholar
Jones, D. P. H. (1987) The untreatable family. Child Abuse and Neglect, 11, 409–420.Google Scholar
Kavoussi, R. J., Kaplan, M. & Becker, J. V. (1988) Psychiatric diagnoses in adolescent sex offenders. Journal of American Academy of Child and Adolescent Psychiatry, 27, 241–243.Google Scholar
Kelly, R. J. (1990) Confidentiality issues with incest perpetrators: duty to report, duty to protect and duty to treat. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. L., Johnson, B. L., Roundy, L. M., et al), pp. 238 245. London: Sage.Google Scholar
Kluft, R. P. (ed.) (1985) Childhood Antecedents of Multiple Personality. Washington, DC: American Psychiatric Press.Google Scholar
Knopp, F. & Lackey, L. (1989) Female Sexual Abusers: A Summary of Data from 44 Treatment Providers. Orwell: Safer Society Press.Google Scholar
Laws, B. (ed.) (1989) Relapse Prevention with Sex Offenders. New York: Guilford.Google Scholar
MacLeod, M. & Saraga, E. (1988) Challenging the orthodoxy: towards a feminist theory and practice. Feminist Review, 28, 16–55.Google Scholar
Mann, D. (1989) Incest: the father and the male therapist. British Journal of Psychotherapy, 6, 143–153.Google Scholar
Markowe, H. L. (1988) The frequency of childhood sexual abuse in the UK. Health Trends, 20, 2–6.Google Scholar
Mrazek, P. J. & Mrazek, D. A. (1987) Resilience in child maltreatment victims: a conceptual exploration. Child Abuse and Neglect, 11, 357–366.Google Scholar
Mullen, P. E., Romans-Clarkson, S. E., Walton, V. A., et al (1988) Impact of sexual and physical abuse on women's mental health. Lancet, ii, 841–845.Google Scholar
Nasjleti, M. (1980) Suffering in silence: the male incest victim. Child Welfare, 59, 269–275.Google Scholar
Nelki, J. S. & Waiters, J. (1989) A group for sexually abused young children: unravelling the web. Child Abuse and Neglect, 13, 369–377.Google Scholar
O'Connell, M. A. (1986) Reuniting incest offenders with their families. Journal of Interpersonal Violence, 1, 374–386.Google Scholar
Peake, A. (1989) Planning group work for boys. In Working with Sexually Abused Boys: An Introduction for Practitioners (eds Armstrong, H. & Hollows, A.), pp. 41–48. London: National Childrens' Bureau.Google Scholar
Pierce, L. & Pierce, R. (1987) Incestuous victimisation by juvenile sex offenders. Journal of Family Violence, 2, 351–364.Google Scholar
Pierce, L. & Pierce, R. (1990) Adolescent/sibling incest perpetrators. In The Incest Perpetrator: A Family Member No One Wants to Treat (eds Horton, A. L., Johnson, B. L., Roundy, L. M., et al), pp. 99–107. London: Sage.Google Scholar
Porter, F. S., Blick, L. C. & Sgroi, S. M. (1982) Treatment of the sexually abused child. In Handbook of Clinical Intervention in Child Sexual Abuse (ed. Sgroi, S. M.). Lexington, Mass.: Lexington Books.Google Scholar
Rogers, C. & Terry, T. (1984) Clinical intervention with boy victims of sexual abuse. In Victims of Sexual Aggression: Treatment of Children, Women and Men (eds Stuart, I. R. & Greer, J. G.). New York: Van Nostrand & Reinhold.Google Scholar
Rutter, M. (1985) Resilience in the face of adversity: protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598–611.Google Scholar
Ryan, T. S. (1986) Problems, errors and opportunities in the treatment of father-daughter incest. Journal of Interpersonal Violence, 1, 113–124.Google Scholar
Salter, A. C. (1988a) Offender denial. In Treating Child Sexual Offenders and Victims: A Practical Guide, pp. 96–110. London: Sage.Google Scholar
Salter, A. C. (1988b) Offender treatment. In Treating Child Sexual Offenders and Victims: A Practical Guide, pp. 111–130. London: Sage.Google Scholar
Schechter, M. D. & Roberge, L. (1976) Sexual exploitation. In Child Abuse and Neglect: The Family and the Community (eds Heifer, R. E. & Kempe, C. H.). Cambridge, Mass.: Ballinger.Google Scholar
Sgroi, S. M. (ed.) Family treatment. In Handbook of Clinical Intervention in Child Sexual Abuse, pp. 241–267. Lexington, Mass.: Lexington Books.Google Scholar
Sgroi, S. M. & Dana, N. T. (1982) Individual and group treatment of mothers of incest victims. In Handbook of Clinical Intervention in Child Sexual Abuse (ed. Sgroi, S. M.). Lexington, Mass.: Lexington Books.Google Scholar
Sgroi, S. M. & Bunk, B. S. (1988) A clinical approach to adult survivors of child sexual abuse. In Vulnerable Populations: Evaluations and Treatment of Sexually Abused Children and Adult Survivors, Vol. I (ed. Sgroi, S. M.), pp. 137–186. Lexington, Mass.: Lexington Books.Google Scholar
Sirles, E. & Franke, P. (1989) Factors influencing mothers' reactions to intra-family sexual abuse. Child Abuse and Neglect, 13, 131–139.Google Scholar
Sirles, E. & Lofberg, C. (1990) Factors associated with divorce in intrafamily child sexual abuse cases. Child Abuse and Neglect, 14, 165–170.Google Scholar
Summit, R. C. (1983) The child sexual abuse accommodation syndrome. Child Abuse and Neglect, 1, 177–193.Google Scholar
Vanden Bos, G. R. (1986) Psychotherapy research. American Psychologist, 41, 111–214.Google Scholar
Weldon, E. V. (1988) Mother, Madonna, Whore: The Idealisation and Denigration of Motherhood. London: Free Association Books.Google Scholar
Wild, N. J. (1989) Prevalence of child sex rings. Paediatrics, 83, 553–558.Google Scholar
Wilkins, R. (1990) Women who sexually abuse children. British Medical Journal, 300, 1153–1154.Google Scholar
Wolf, S., Conte, J. R. & Engel-Meinig, M. (1988) Assessment and treatment of sexual offenders in a community setting. In A Handbook on Sexual Abuse of Children (ed. Walker, L.). New York: Springer.Google Scholar
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