Bibliography 1
Child Sexual Abuse and Foster Care: An Annotated Bibliography
Trica L. Peterson B.A. doctoral Student
Debra Gerrity, Assistant Professor
Counseling, Educational School of Psychology
State University of New York at Buffalo
Jere Wrightsman, Foster Care Director
CDHS, Albany New York Office
Funding for this research project was provided by NYS Office of Children and Family Services,
Contract year 2001: Award: 20058; Project: 10144, Task: 4.1.2 through the Center for
Development of Human Services, College Relations Group, Research Foundation of SUNY,
Buffalo State College.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 2
Abstract
The purpose of this annotated bibliography is to provide foster care trainers and related personnel
with updated research concerning childhood sexual abuse, foster care issues, and the interaction
of those constructs. While the annotated bibliography can stand alone as a brief summary of
relevant articles in these areas, it is our intention to use the gathered information as a tool in the
development of the forthcoming handbook titled, “Child Sexual Abuse: A Resource Guide for
Parents, Foster Parents, and Caseworkers”. As research informs practice and vice versa, it is
imperative that current, empirical knowledge be utilized in the creation of any practical manual
on these topics.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 3
Reference List
Bukowski, W. M. (1992). Sexual abuse and maladjustment considered from the perspective of
normal developmental processes. In W. O’Donohue & J. H. Geer (Eds.), The sexual
abuse of children: Theory and research, volume 1 (pp. 261-282). Hillsdale, NJ:
Lawrence Erlbaum Associates.
Chu, J. A., & Dill. D. L. (1990). Dissociative symptoms in relations to childhood physical and
sexual abuse. American Journal of Psychiatry, 147, (7), 887-892.
DeMaio, R. X. (1995). Helping families become places of healing: Systemic treatment of
intrafamilial sexual abuse. In L. C. Graham (Ed.), Children in families at risk:
Maintaining the connections (pp. 125-149). New York, NY: Guilford.
Faller, K. C. (1990). Understanding child sexual maltreatment. New bury Park, CA: Sage.
Gaines, T. (1986). Applications of child group psychotherapy. In A. E. Reister & I. A. Kraft
(Eds.), Child group psychotherapy: Future tense (pp. 103-121). Madison, CT:
International Universities Press, Inc.
Gallagher, M. M., Leavitt, K. S., & Kimmel, H. P. (1995). Mental health treatment of
cumulatively/repetitively traumatized children. Smith College Studies in Social Work,
65(3), 205-237.
Green, A. M. (1992). Applications of psychoanalytic theory in the treatment of the victim and
the family. In W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children:
Clinical issues, volume 2 (pp. 285-300). Hillsdale, NJ: Lawrence Erlbaum Associates.
Gutierres, S. E., & Todd, M. (1997). The impact of childhood abuse on treatment outcomes of
substance users. Professional Psychology: Research and Practice, 28(4), 348-354.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 4
Hansen, D. J., Hecht, D. B., & Futa, K. T. (1998). Child sexual abuse. In V. B. VanHasselt &
M. Hersen (Eds.), Handbook of Psychological treatment protocols for children and
adolescents (pp. 153-178). Mahwah, NJ: Lawrence Erlbaum Associates.
Heflin, A. H., & Deblinger, E. (1996). Treatment of an adolescent survivor of child sexual
abuse. In M. A. Reinke, F. M. Datillio, & A. Freeman (Eds.), Cognitive therapy with
children and adolescents (pp. 199-225). New York, NY: Guilford.
Hoier, T. S., Shawchuck, C. R., Pallotta, G. M., Freeman, T., Inderbitzen-Pisaruk, H.,
MacMillan, V. M., Malinosky-Rummell, R., & Greene, A. L. (1992). The impact of
sexual abuse: A cognitive-behavioral model. In W. O’Donohue & J. H. Greer (Eds.), The
sexual abuse of children: Clinical issues, volume 2 (pp. 100-142). Hillsdale, NJ:
Lawrence Erlbaum Associates.
Homeyer, L. E. (1999). Group play therapy with sexually abused children. In D. S. Sweeney &
L. E. Homeyer (Eds.), The handbook of group play therapy (pp. 29-318). San Francisco,
CA: Jossey-Bass.
Homstead, K. C., & Werthamer, L. (1988). Time-limited group therapy for female adolescent
victims of child sexual abuse. In S. M. Sgroi (Ed.), Vulnerable populations, Volume 2
(pp. 65-84). New York, NY: Lexington Books.
Jehu, D. (1989). Mood disturbances among women clients sexually abused in childhood:
Prevalence, etiology, treatment. Journal of Interpersonal Violence, 4(2), 164-184.
Johnson, T. C., & Berry, C. (1989). Children who molest: A treatment program. Journal of
Interpersonal Violence, 4(2), 185-203.
Knell, S. M., & Roma, C. D. (1996). Play therapy with a sexually abused child. In M. A.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 5
Reinke, F. M. Datillio, & A. Freeman (Eds.), Cognitive therapy with children and
adolescents (pp. 367-393). New York, NY: Guilford.
Lawry, S. S. Touch and clients who have been sexually abused. In Insights from Practice,
chapter in edited book, source unknown.
Leavitt, F., & Labott, S. M. (1996). Authenticity of recovered sexual abuse memories: A
Rorschach study. Journal of Traumatic Stress, 9(3), 483-496.
Lindsey, E. W. (2001). Foster family characteristics and behavioral and emotional problems of
foster children: Practice implications for child welfare, family life education, and
marriage and family therapy. Family Relations, 50(1), 19-22.
Mandell, J.G., & Damon, L. (1989). Group treatment for sexually abused children. New York,
NY: Gilford Press.
Marvasti, J. A. (1988). Play therapy with sexually abused children. In S. M. Sgroi (Ed.),
Vulnerable populations, Volume 2 (pp. 1-41). New York, NY: Lexington Books.
Minuchin, P. (1995). Foster and natural families: Forming a cooperative network. In L. C.
Graham (Ed.), Children in families at risk: Maintaining the connections (pp. 251-274).
New York, NY: Guilford.
Nicholas, M., & Forrester, A. (1999). Advantages of heterogeneous therapy groups in the
psychotherapy of the traumatically abused: Treating the problem as well as the person.
International Journal of Group Psychotherapy, 49(3), 323-342.
Palmer, K. D., Baker, R. C., & McGee, T. F. (1997). The effects of pretraining on group
psychotherapy for incest-related issues. International Group Psychotherapy, 47(1), 7188.
Pescosolido, F. J., & Petrella, D. M. (1986). The development, process, and evaluation of group
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 6
psychotherapy with sexually abused preschool girls. International Journal of Group
Psychotherapy, 36(3), 447-469.
Pfeifer, G. (1992). Complementary cultures in children’s psychotherapy groups: Conflict,
coexistence, and convergence in group development. International Journal of Group
Psychotherapy, 42(3), 357-368.
Reynolds-Mejia, P., & Levitan, S. (1990). Countertransference issues in the in-home treatment
of child sexual abuse. Child Welfare, LXIX(1), 53-61.
Rosen, R. C., & Hall, K. S. K. (1992). Behavioral treatment approaches for offenders and
victims. In W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical
issues, volume 2 (pp. 301-330). Hillsdale, NJ: Lawrence Erlbaum Associates.
Salter, A. C. (1992). Epidemiology of child sexual abuse. In W. O’Donohue & J. H. Geer
(Eds.), The sexual abuse of children: Theory and research, volume 1 (pp. 108-138).
Hillsdale, NJ: Lawrence Erlbaum Associates.
Schacht, A. J., Kerlinsky, D., & Carlson, C. (1990). Group therapy with sexually abused boys:
Leadership, projective identification, and countertransference issues. International
Journal of Group Psychotherapy, 40(4), 401-417.
Schamess, G., Streider, F. H., & Connors, K. M. (1997). Supervision and staff training for
children’s group psychotherapy: General principles and applications with cumulatively
traumatized, inner-city children. International Journal of Group Psychotherapy, 47(4),
399-425.
Stevenson, J. (1999). The treatment of the long-term sequelae of child abuse. Journal of Child
Psychology and Psychiatry, 40(1), 89-111.
Sturkie, K. (1992). Group treatment of child sexual abuse victims: A review. In W. O’Donohue
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 7
& J. H. Greer (Eds.), The sexual abuse of children: Clinical issues, volume 2 (pp. 331364). Hillsdale, NJ: Lawrence Erlbaum Associates.
Weille, K. L. H. (1997). The dynamics of sexual victimization/victimizing in the members of a
child sexual abuse group: Exploring the theoretical role of shame. Smith College Studies
in Social Work, 67(2), 225-239.
Wolfe, V. V., & Gentile, C. (1992). Psychological assessment of sexually abused children. In
W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical issues,
volume 2 (pp. 143-187). Hillsdale, NJ: Lawrence Erlbaum Associates.
Zamanian, K., & Adams, C. (1997). Group psychotherapy with sexually abused boys: Dynamics
and interventions. International Journal of Group Psychotherapy, 47(1), 109-126.
Zivney, O. A., Nash, M. R., & Hulsey, T. L. (1988). Sexual abuse in early versus late childhood:
Differing patterns of pathology as revealed on the Rorschach. Psychopathology, 25(1),
99-106.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 8
Bukowski, W. M. (1992). Sexual abuse and maladjustment considered from the perspective of
normal developmental processes. In W. O’Donohue & J. H. Geer (Eds.), The sexual abuse of
children: Theory and research, volume 1 (pp. 261-282). Hillsdale, NJ: Lawrence Erlbaum
Associates. Located at Lockwood Memorial Library at the State University of New York at
Buffalo, Amherst campus.
This is a highly conceptual chapter that describes the potential impact of childhood
sexual abuse on three separate developmental processes, which are socialization, the
development of self-concept, and sexuality. The chapter first describes the manner in which
each of the three processes normally develops and then discusses the repercussions of sexual
abuse. With regard to socialization, the author states that abused children are often unable to
develop appropriate socialization due to tumultuous home lives and, in many cases, parental
neglect. The abusive act is also thought to make the child an object, which impedes his/her
ability to form a sense of self. Additionally, the violation of normal sexual development makes
further normal development extremely difficult.
Chu, J. A., & Dill. D. L. (1990). Dissociative symptoms in relations to childhood physical and
sexual abuse.
American Journal of Psychiatry, 147, (7), 887-892.
Located in Lockwood
Memorial Library at the State University of New York at Buffalo, Amherst campus.
In this study, 98 female, psychiatric inpatients between the ages of 18 and 60 completed
three self-report measures in an effort to gather data regarding the presumed connection of
childhood abuse and dissociative symptoms in adulthood.
Researchers hypothesized that
dissociative symptoms in these patients would be greater for those who had experienced
childhood abuse, in some form, than for those patients who had not. The measures administered
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 9
included the Dissociative Symptoms Scale, the SCL-90-R, and the Life Experiences
Questionnaire. Additional information regarding diagnosis, presenting symptoms, and prior
treatment history was also taken from the patients’ medical records.
A two-by-two ANOVA was conducted to cross high dissociative scores with reported
physical and sexual childhood abuse. Overall, childhood abuse of any kind, physical or sexual,
was related to high dissociative symptoms in adulthood. The highest occurrence of symptoms
was reported in those who had experienced both physical and sexual abuse, although those who
experienced one form of abuse by immediate family members had extremely high numbers of
reported symptoms, as well. Of the 35 reporters of childhood sexual abuse (CSA), only one
stated that they had reported it around the time of the actual abuse onset. Additionally, 29 of
those 35 participants believed that CSA was related to their current psychiatric symptoms. In
this study, CSA doubled the risk of concurrent physical abuse and adult sexual abuse in
participants.
DeMaio, R. X. (1995). Helping families become places of healing: Systemic treatment of
intrafamilial sexual abuse. In L. C. Graham (Ed.), Children in families at risk: Maintaining the
connections (pp. 125-149). New York, NY: Guilford. Located in Lockwood Memorial Library
at the State University of New York at Buffalo, Amherst campus.
The author of this book chapter provides a family systems approach to treating sexual
abuse that is informed by feminist theory. Approaches for dealing with the issues commonly
confronted in session are described. Some of the behaviors mentioned were: denial, sexual
acting out and dissociation. The goal of this form of therapy is to increase empathy and
mutuality in the family in order to provide a “context for healing”.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 10
Faller, K. C. (1990). Understanding child sexual maltreatment. New bury Park, CA: Sage.
Located in Lockwood Memorial Library at the State University of New York at Buffalo,
Amherst campus.
This book gives the reader a thorough background regarding the legal definitions and
interventions for child sexual abuse. It addresses topics such as how to assess for risk and how
to determine validity of claims. Although several statistics regarding incidence and prevalence
are included, the most recent is a 1988 telephone poll for the L.A. Times, stating that 27% of
women and 16% of men had experienced sexual abuse.
Gaines, T. (1986). Applications of child group psychotherapy. In A. E. Reister & I. A. Kraft
(Eds.), Child group psychotherapy: Future tense (pp. 103-121). Madison, CT: International
Universities Press, Inc. Book located in Lockwood Memorial Library at the State University of
New York at Buffalo, Amherst campus.
This book chapter discusses the use of group psychotherapy with several different
populations of children.
In a section involving the treatment of abused children, Gaines
describes the negative impact of abuse on children. He cites poor self-concept, low frustration
tolerance, poor attention span, and many other issues as documented effects of abuse. The
author also emphasizes the need for direct, structured groups for latency aged children. A
parallel group for offending adults is also encouraged.
Gallagher, M. M., Leavitt, K. S., & Kimmel, H. P. (1995). Mental health treatment of
cumulatively/repetitively traumatized children. Smith College Studies in Social Work, 65(3),
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 11
205-237. Located in Lockwood Memorial Library at the State University of New York at
Buffalo, Amherst campus.
This article presupposes that children who have experienced multiple traumas require a
different treatment approach than other traumatized children. The authors explain the varying
theoretical views of trauma and the known impact of trauma as it exists in the current literature.
Terr’s (1991) model of Type I (one specific) and Type II (long-standing) trauma is expanded
upon in this article by adding a proposed Type III trauma that would include early failures in
caretaker-child relationships, as well as Type II traumas. This is a long and in-depth look at
counseling this population with specific examples provided for each of the concepts presented.
Overall, the purpose of the article is to present a 3 stage model of treatment for
cumulatively/repetitively traumatized children.
The model was devised from 10 years of
therapeutic experience with children in schools and other outpatient settings. Most of the
children were living “in poverty, moved through many placements in the child welfare system,
and experienced a chronic history of abuse and/or neglect”.
In Stage I of this model, the goal is to stabilize the children’s overall functioning by
creating a holding environment that encourages feelings of competence and general well-being.
It is also important to establish adults as protectors in the eyes of the child. The therapeutic goal
during Stage II is threefold: to have the child tell their story, to provide corrective emotional
experiences, and to teach the child different behaviors to replace their automatic responses to the
trauma. For Stage III, the focus shifts to enabling the child to form and maintain relationships in
the outside world.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 12
Green, A. M. (1992). Applications of psychoanalytic theory in the treatment of the victim and
the family. In W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical
issues, volume 2 (pp. 285-300). Hillsdale, NJ: Lawrence Erlbaum Associates. Book located at
Lockwood Memorial Library at the State University of New York at Buffalo, Amherst campus.
In this chapter, the author begins by discussing Freud’s views toward the creation and
treatment of trauma in clients.
Green states that psychoanalytically oriented treatment is
appropriate for this population because it deals with both the immediate and long-term
consequences of sexual abuse. The bulk of the chapter describes the various treatment issues
addressed in psychoanalytic therapy. Some of the issues mentioned are: acute traumatization,
stigmatization, betrayal, role confusion, premature sexualization, and countertransference
problems.
The chapter also briefly discusses the preparation of abused children for court
appearances and working with families dealing with incest.
Gutierres, S. E., & Todd, M. (1997). The impact of childhood abuse on treatment outcomes of
substance users. Professional Psychology: Research and Practice, 28(4), 348-354. Located in
Lockwood Memorial Library at the State University of New York at Buffalo, Amherst campus.
The purpose of this exploratory study was to assess the prevalence and impact of
childhood sexual, emotional, and physical abuse among 146 male and female, substance users in
residential treatment. In order to assess the impact of childhood abuse, the study examined the
effect of reported abuse on self-esteem and depression and the relationship between reported
abuse and treatment outcomes. Participants were grouped according to ethnicity to for three
groups, Mexican-American, American Indian, and Anglo-American. Although the age range
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 13
was 18 to 59 years, ANOVA’s and Chi Square analysis found no gender differences regarding
age, marital status, or education.
To conduct the study, participants were interviewed and completed questionnaires at the
beginning and end of treatment. Demographic information was obtained at each interview, as
well as data from the Rosenberg Self-Esteem Scale and Beck Depression Inventory. Treatment
completion was assessed in two ways: by determining if the client dropped out of the program
before completion and by getting a counselor’s prognosis of how the client would respond to
release from the program. Counselors gave ratings from one to five, with three or higher
indicating successful completion of the program.
Overall, women who reported abuse maintained lower self-esteem scores than those who
did not report abuse. Low levels of self-esteem persisted, even at termination of treatment.
Although those who reported abuse had higher depression scores than non-reporters at entry into
the program, this was not the case at termination. Reported abuse was not related to treatment
completion. Interestingly, 79 percent of the female participants and 41 percent of the male
participants reported some form of abuse in their history. Several recommendations regarding
the alteration of substance abuse programs were also provided in the article.
Hansen, D. J., Hecht, D. B., & Futa, K. T. (1998). Child sexual abuse. In V. B. VanHasselt &
M. Hersen (Eds.), Handbook of Psychological treatment protocols for children and adolescents
(pp. 153-178).
Mahwah, NJ: Lawrence Erlbaum Associates.
Received from Dr. Deborah
Gerrity out of her personal library.
Rationale for and a description of a treatment protocol for group therapy for victims of
child sexual abuse is provided in this book chapter. The treatment program, called Project SAFE
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 14
(Sexual Abuse Family Education), consists of 12, weekly, 90-minute sessions. Stipulations
regarding coleader and participant selection are included, as well as step-by-step instructions for
each of the 10 treatment modules. A 3-factor model is employed to identify the therapeutic
targets, which are: self (self-esteem, guilt), relationships (peer, family), and sex (sexual and
abuse-specific knowledge). Nonabusive parents are also included in a parallel, but separate
group. Several child and parent self-report measures are examined, along with reliability ad
validity information for each.
Heflin, A. H., & Deblinger, E. (1996). Treatment of an adolescent survivor of child sexual
abuse. In M. A. Reinke, F. M. Datillio, & A. Freeman (Eds.), Cognitive therapy with children
and adolescents (pp. 199-225). New York, NY: Guilford. Book located in Lockwood Memorial
Library at the State University of New York at Buffalo, Amherst campus.
In this chapter, the authors describe the importance of effective treatment for sexual
abuse in adolescents and provide a cognitive behavioral treatment approach. According to the
authors, 27% of females and 16% of males will be sexually abused by the age of 18.
Adolescents are also stated to have the most severe psychological and psychosocial difficulties in
response to the abuse.
Some of the mediating factors listed by the authors include: the
relationship to the perpetrator, invasiveness of the sexual encounter, the threat or use of force,
and the role of nonoffending parents. The rest of the chapter provides a case study of an
adolescent victim of sexual abuse. A treatment plan is presented that combines treatment
programs for childhood sexual abuse and adult rape victims. One of the major changes noted to
the childhood sexual abuse treatment program is the increased emphasis on sexuality and dating
concerns. In terms of treatment phases, both the parents and the child are given education
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 15
regarding sexual abuse and coping skills training. Parents are also given parenting skills
education. The child is gradually exposed to the anxiety provoking stimuli associated with the
abusive experience in order to work through the related thoughts and feelings. An emphasis is
also placed on establishing joint sessions between the child and parents.
Hoier, T. S., Shawchuck, C. R., Pallotta, G. M., Freeman, T., Inderbitzen-Pisaruk, H.,
MacMillan, V. M., Malinosky-Rummell, R., & Greene, A. L. (1992). The impact of sexual
abuse: A cognitive-behavioral model. In W. O’Donohue & J. H. Greer (Eds.), The sexual abuse
of children: Clinical issues, volume 2 (pp. 100-142).
Hillsdale, NJ: Lawrence Erlbaum
Associates. Book located at Lockwood Memorial Library at the State University of New York at
Buffalo, Amherst campus.
The purpose of this chapter is to promote the use of a cognitive behavioral approach to
treatment conceptualization for victims of sexual abuse. A challenge-stress-trauma continuum is
presented, whereby severity of the experience is determined by the intensity, duration, frequency,
and uncontrollability of the experience. The stimulus-response aspects of the abuse episode and
resultant responses are also discussed as follows: classically conditioned responses (increased
physiological arousal), negative reinforcement (escape and avoidance behaviors), positive
reinforcement (creation of sexualized behaviors), punishment and extinction (decrease in selfdefensive behaviors due to helplessness), and cognitive processes (negative self-attributions).
Directions for future research are also included.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 16
Homeyer, L. E. (1999). Group play therapy with sexually abused children. In D. S. Sweeney &
L. E. Homeyer (Eds.), The handbook of group play therapy (pp. 29-318). San Francisco, CA:
Jossey-Bass. Received from the personal library of Dr. Deborah Gerrity at the State University
of New York at Buffalo, Amherst campus.
The importance and benefits of group play therapy with child sexual abuse survivors is
vocalized in this book chapter. The author highlights the need to engage the child in therapy as
quickly as possible, in order to limit the number of defenses that have come into action.
Screening and selection issues are also discussed at length. Behaviors associated with each of
the traumagenic factors (traumatic sexualization, stigmatization, betrayal, powerlessness) are
highlighted in the chapter.
For example, stigmatization behaviors include: self-destructive
behavior, gravitating toward others who feel stigmatized, and many others. Discussion regarding
appropriate limit setting and combating problem behaviors (abuse re-enactment, masturbation,
etc.) in group are also discussed.
Homstead, K. C., & Werthamer, L. (1988). Time-limited group therapy for female adolescent
victims of child sexual abuse. In S. M. Sgroi (Ed.), Vulnerable populations, Volume 2 (pp. 6584). New York, NY: Lexington Books. Book located in Lockwood Memorial Library at the
State University of New York at Buffalo, Amherst campus.
This book chapter describes the Adolescent Sexual Abuse Treatment (ASAT) program
used in Northampton, MA. The authors cite claims from other authors regarding the efficacy of
group therapy with this population. Some of the benefits mentioned are a decrease in feelings of
isolation, less pressure than individual therapy to disclose information, and the opportunity to
express feelings toward another person’s situation that these children are unable to show for
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 17
themselves. Through consistency, modeling, and education, the authors propose the ASAT
program to be a safe and therapeutically useful approach to treatment for sexually abused
adolescents. Group developmental stages and typical pitfalls/difficulties are also included in the
chapter.
Jehu, D. (1989).
Mood disturbances among women clients sexually abused in childhood:
Prevalence, etiology, treatment. Journal of Interpersonal Violence, 4(2), 164-184. Located in
Lockwood Memorial Library at the State University of New York at Buffalo, Amherst campus.
A sample of 51 women with current mood disturbances and histories of child sexual
abuse was studied at the University of Manitoba to determine the effectiveness of using cognitive
restructuring techniques in therapy.
It was hypothesized that the mood disturbances being
experienced were caused by distorted beliefs still held by the participants concerning their
previous abuse. Additionally, it was hypothesized that cognitive restructuring of the inaccurate
beliefs would lead to the relief of symptoms.
For inclusion in the study, participants had to meet three criteria. First, the women had to
be over 18 years of age, have at least an 8th grade education, and not currently be in crisis.
Second, the previous sexual abuse must have occurred on more than one occasion and included
genital contact. Lastly, the offender must have known the victim prior to the abuse and either
have been five years older than a victim aged 12 or under, or have been ten years older than a
victim aged 13 to 16 years of age. The sample was predominantly Caucasian, while the other 24
percent of the sample were Meti, native Indian, or Inuit.
At the outset of the study, participants were interviewed concerning demographic
information and completed the Belief Inventory, Beck Depression Inventory, and either the
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 18
Battle Self-Esteem Inventory, or the Hudson Index of Self-Esteem. The scales were again
administered at termination and at follow-up. Only a few of the techniques used in therapy
sessions were presented and explained in the article, which were provision of information,
logical analysis of beliefs, decatastrophizing, distancing, reattribution, and assigned activities.
Individual sessions with the participants were conducted by a female therapist, “in almost all
cases”. The average length of therapy was 21 weeks, with one participant attending for 3 weeks
and at least one participant attending for 47 weeks. One follow-up session with each participant
occurred between 8 and 135 weeks after termination.
To analyze the data, a one-way repeated measures ANOVA was used on the results of
each of the scales, except the Battle Self-Esteem Inventory. The data from that scale were not
analyzed at all, due to unspecified problems. Post hoc comparisons were also conducted using
Tukey’s multiple range comparison technique. On all three included measures, results indicated
a significant improvement from the start of therapy to termination, with the improvements being
maintained at follow-up. In addition, beneficial side effects from therapy were reported by 31
percent of the participants with regard to their marital relationship and 52 percent with regard to
sexual functioning.
Johnson, T. C., & Berry, C. (1989). Children who molest: A treatment program. Journal of
Interpersonal Violence, 4(2), 185-203. Located in Lockwood Memorial Library at the State
University of New York at Buffalo, Amherst campus.
In this article, a description of a treatment program for child perpetrators of sexual abuse
is provided. The goals of the program are to eradicate sexually abusive behavior, understand its
causes, and train mental health workers on these issues. Perpetrators, between the ages of 4 and
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 19
13, and their families participate in a series of intake assessments to determine their eligibility for
the program. After these initial meetings, each child in the family and the parents attend group
therapy. In most cases, family and individual therapy was provided, as well.
During the initial intake session, the Roberts Apperception Test, Peabody Picture
Vocabulary Test, Purdue Measure of Self Concept, and the Nowicki Test of Locus of Control
were administered. Parental interviews provided psychosocial information concerning the child
and each of the family members.
Parents also completed the Achenbach Child Behavior
Checklist, and the Adult/Adolescent Parenting Inventory.
Once accepted into the program, each family member was provided with an
individualized treatment plan. Separate groups were established for parents, child perpetrators,
victimized siblings, and non-victimized siblings.
In the article, common personality and
behavioral indicators were described for members in each of the groups.
Knell, S. M., & Roma, C. D. (1996). Play therapy with a sexually abused child. In M. A.
Reinke, F. M. Datillio, & A. Freeman (Eds.), Cognitive therapy with children and adolescents
(pp. 367-393). New York, NY: Guilford. Book located in Lockwood Memorial Library at the
State University of New York at Buffalo, Amherst campus.
A cognitive behavioral treatment plan is provided in this chapter for treatment of
childhood sexual abuse through play therapy. The authors describe their approach as a directive
program that is suitable for pre-school and school-age children. Topics addressed in this play
therapy program include responsibility for change, control, and mastery.
A coping-model
approach is employed, whereby therapists model appropriate coping skills through the use of
puppets and dolls. Other play therapy techniques described in the chapter include: bibliotherapy,
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 20
drawings, and artwork. Ideas regarding implementation of each of these techniques are also
provided. A case study is also presented in order to explain the process involved in each stage of
therapy.
Lawry, S. S. Touch and clients who have been sexually abused. In Insights from Practice,
chapter in edited book, source unknown. Received from Dr. Deborah Gerrity at the State
University of New York at Buffalo, Amherst campus.
The issue of when and when not to use touch with adult survivors of sexual abuse is
presented in the article. It begins with a short discussion regarding a therapist’s personal comfort
with touch, stating that once a therapist feels comfortable using touch, several questions must be
posed regarding the therapist’s and client’s motivations. Questions posed to therapists include:
“How do I feel about touch personally?”, and “Am I attracted to this client?”. Questions asked
regarding the client include: “What client need is being met by touch, and is touch the only way
of meeting that need?”, “Does my client have sufficient ego strength?”, “What level of
dissociation/depersonalization is the client currently experiencing?”, “Is my client seeking sexual
gratification from me?”, and “Is the relationship developed and balanced enough to withstand the
potential intensity of touch?”. The positive role of touch in combating stigmatization, betrayal,
powerlessness, and sexualization is also examined.
Leavitt, F., & Labott, S. M. (1996). Authenticity of recovered sexual abuse memories: A
Rorschach study. Journal of Traumatic Stress, 9(3), 483-496. Located in Lockwood Memorial
Library, State University of New York at Buffalo, Amherst campus.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 21
This study investigated the ability of 13 Rorschach signs to determine the accuracy of
childhood sexual abuse claims. The majority of the participants were Caucasian, between the
ages of 18 and 60 years old. All 174 participants were female, psychiatric inpatients who were
placed into one of three groups (Abuse Aware, Nonabused, Recovered Memory) based on their
sexual abuse history. Participants in the recovered memory group were then divided based on
dissociative responses given during testing. Those with one or more dissociative responses on
the Rorschach were placed in the recovered memory-dissociative group, while those with no
dissociative responses were placed in the recovered memory-nondissociative group. It was
hypothesized that amnesia of childhood sexual abuse is prompted by dissociation. Therefore,
participants in the recovered memory-dissociative group were expected to show signs of sexual
abuse on the Rorschach, while those in the recovered memory-nondissociative group were not.
To conduct the study, researchers administered a psychosocial interview and the
Rorschach test. Thirteen Rorschach variables were selected for scoring based on previous
research with sexually abused groups. Scoring was performed following the Beck method. The
reliability of scoring was obtained through Pearson-product moment correlations, while a oneway ANOVA was utilized to assure that there was no significant difference in number of
responses between groups. Through Chi Square analysis, eight of the original 13 variables were
retained for further analysis, as 7 of those 8 significantly differentiated dissociative participants
from nondissociative participants in the recovered memory group. Computation of a sexual
abuse index was then conducted for each participant, yielding a frequency table with signs of
sexual abuse by group.
Results of this study indicate that the Rorschach test can detect the after-effects of
childhood sexual abuse. The 8 variables were able to distinguish between sexually abused
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 22
women and those that were not, with great accuracy. Nondissociative members of the recovered
memory group, however, tended to score most similarly to the nonabused group. A possible
explanation provided for that finding was that the Rorschach test does not have a variable to
account for differences in the age of abuse onset, and that 56 percent of the nondissociative
group members reported onset before the age of 3 years old.
Lindsey, E. W. (2001). Foster family characteristics and behavioral and emotional problems of
foster children: Practice implications for child welfare, family life education, and marriage and
family therapy. Family Relations, 50(1), 19-22. Located in Lockwood Memorial Library at the
State University of New York at Buffalo, Amherst campus.
The main focus of the article is to highlight the extreme need for research within foster
families. According to the author, the majority of current research involves less than reliable
instrumentation and methodology, making generalization and implementation of results difficult.
For the most part, the article discusses the screening, selection, and training of foster parents,
emphasizing the need to assess parenting behavior, the home environment, and family and
marital functioning. “Goodness of fit” between parents, family, and the child in a foster home is
seen as crucial. Due to overcrowding in the foster system, however, effective assessment
regarding fit is often unlikely.
Mandell, J.G., & Damon, L. (1989). Group treatment for sexually abused children. New York,
NY: Gilford Press. Book located in Lockwood Memorial Library at the State University of New
York at Buffalo, Amherst campus.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 23
In this book, the effects of childhood sexual abuse and the use of group treatment for
those effects are presented. The authors list over-sexualized behaviors, acting out behaviors to
test limits with parents, sleep disturbances, depression, suicidal gestures, and several other issues
as potential adverse reactions to sexual abuse in children. Guidelines for the selection and
preparation of children and their caretakers for group therapy are also provided. With regard to
caretaker selection, the authors support the involvement of foster parents in the parallel, adult
therapy group, as long as the foster parent is “adequately emotionally involved” with the child.
The last portion of the book consists of weekly treatment modules, giving examples of potential
topics and interventions for the group itself.
Marvasti, J. A. (1988). Play therapy with sexually abused children. In S. M. Sgroi (Ed.),
Vulnerable populations, Volume 2 (pp. 1-41). New York, NY: Lexington Books. Book located
in Lockwood Memorial Library at the State University of New York at Buffalo, Amherst
campus.
In this chapter, the author explains that play therapy has two distinct parts, which are
diagnosis and therapy. During the diagnosis phase, the therapist’s main goal is to establish a
relationship with the child and determine the emotional difficulties being experienced. Defense
mechanisms and conflict resolution styles will also be observed. Once in the therapy stage, the
therapist attempts to “undo” the defense mechanisms being used by the child, while allowing the
child to vent their feelings. Several play therapy techniques are presented and explained, such as
the use of projection, role reversal, props, and dreams. The remainder of the chapter provides a
detailed account of what “should” happen in play therapy sessions as treatment progresses.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 24
Minuchin, P. (1995). Foster and natural families: Forming a cooperative network. In L. C.
Graham (Ed.), Children in families at risk: Maintaining the connections (pp. 251-274). New
York, NY: Guilford. Located in Lockwood Memorial Library at the State University of New
York at Buffalo, Amherst campus.
This book chapter presents an ecological model aimed at increasing communication and
support between biological and foster families, and the service providers involved. Highlighting
the goal of foster care, which is to eventually reunite the family, the author asserts that five
themes should be emphasized when working with these clients. These themes are: family
preservation and empowerment, outreach to extended family members, transition is difficult, and
the impact of the child’s developmental stage. Several skills were deemed crucial for foster
families, which were: joining, mapping, searching for strength, and using complementarity.
Each of those skills was described in the chapter. As stated in the title, the author believes that
the goal should be to form a cooperative network between service providers, foster families, and
biological families to assist in the reunification process.
Nicholas, M., & Forrester, A. (1999). Advantages of heterogeneous therapy groups in the
psychotherapy of the traumatically abused: Treating the problem as well as the person.
International Journal of Group Psychotherapy, 49(3), 323-342. Located in Lockwood Memorial
Library at the State University of New York at Buffalo, Amherst campus.
As stated in the article’s title, the main focus of the article is to persuade the reader that
heterogeneous psychotherapy groups are the treatment of choice for those clients who have been
sexually abused. Pros and cons of both heterogeneous and homogeneous group formats are
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 25
presented, along with case examples to illustrate the point being made. Some of the pros listed
for a heterogeneous group format were that issues regarding isolation and stigmatization could
be addressed, new relationships formed, and power imbalances in current relationships could be
examined. In addition to the material concerned with the pros and cons of different types of
group format, the article provided a social history of trauma research, including notable
researchers and the progression of thought from the early 1900’s until today. One additional
caution that was incorporated in the article was a warning about diagnosing trauma survivors
with borderline personality disorder.
Palmer, K. D., Baker, R. C., & McGee, T. F. (1997). The effects of pretraining on group
psychotherapy for incest-related issues.
International Group Psychotherapy, 47(1), 71-88.
Located in Lockwood Memorial Library at the State University of New York at Buffalo,
Amherst campus.
The study investigated the effects of written pretraining on self-reported self-disclosure
and cohesion in an incest-related psychotherapy group.
Researchers hypothesized that
participants who received pretraining would have higher levels of cohesion and self-reported
self-disclosure than those in the control group. It was also anticipated that cohesion and selfreported self-disclosure would increase more quickly over time for members of the pretraining
group than for the control group.
Male and female participants were recruited from Parents United orientation groups and
were then randomly assigned to the pretraining or control group.
Interestingly, group
membership consisted of both perpetrators and survivors of incest. Surveys consisting of the
Schultz Cohesiveness Questionnaire and the Jourard Self-Disclosure Questionnaire were
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 26
administered after session 1, 4, and 8. A demographic questionnaire and the Marlowe-Crowne
Social Desirability Scale were also given after session 4. After session 1, 92 participants were
surveyed. With each additional survey administration, the number of returned surveys decreased
to a final total of 66 participants. Background questionnaires were also administered to the
therapists of the groups to assess age, ethnicity, level of education, and group experience.
Chi Square analysis of the demographic variables showed no significant differences
between experimental and control groups regarding gender, age, ethnicity, or marital status. In
addition, no differences were reported between social desirability scores for either treatment
group. There were also no significant differences in any of the above stated variables on the
therapist surveys. For the rest of the analyses, paired T tests were used to test the research
hypotheses. Overall, participants who were pretrained regarding what to expect in group were
able to develop higher levels of self-reported self-disclosure in the group, than those in the
control group.
Group cohesiveness was also shown to increase over time for pretrained
individuals, but not for members of the control group. Male participants tended to show greater
levels of cohesion than women, while perpetrators showed higher cohesion levels than survivors.
Pescosolido, F. J., & Petrella, D. M. (1986). The development, process, and evaluation of
group psychotherapy with sexually abused preschool girls. International Journal of Group
Psychotherapy, 36(3), 447-469. Located in Lockwood Memorial Library at the State University
of New York at Buffalo, Amherst campus.
The article describes structured, group psychotherapy with six, preschool age girls who
had been sexually abused. The importance of appropriate counseling for this population was
emphasized, especially in light of the developmental, emotional, and cognitive changes that are
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 27
taking place at that age. For these authors, group therapy should focus on the emotional and
behavioral aftermath of the abuse. The primary goal is to address the feelings of isolation that
are common in sexually abused children. Additionally, group structure was to be a mix of
education, prevention, and psychotherapy.
In the one-hour sessions, thirty minutes was allotted for an art or craft activity.
Afterward, the children were provided with a snack and were engaged in a discussion of one of
the therapeutic topics. Some examples of the topics covered were anger, trust, and guilt.
Rationale for utilizing male and female co-therapists was provided. Also, case studies of
each of the six girls in the group were included. The recommendation of the authors was for a
time-limited, 12-week group, and the inclusion of the children’s mothers at different points in the
group. Not surprisingly, children living in intact families tended to show greater improvement
than did those in foster care. The authors attributed this to the chaotic, dysfunctional nature of
the child’s nuclear family.
Pfeifer, G. (1992).
Complementary cultures in children’s psychotherapy groups: Conflict,
coexistence, and convergence in group development.
International Journal of Group
Psychotherapy, 42(3), 357-368. Located in Lockwood Memorial Library at the State University
of New York at Buffalo, Amherst campus.
In very general terms, this article describes the process that therapists go through in
children’s group psychotherapy to provide an open, therapeutic environment. While not a rigid,
stage model of group development, different levels of group functioning are discussed.
Therapists are encouraged to recognize that children’s groups have a set of norms, or indigenous
culture, from the outset. The therapist is not part of that culture, but must attempt to enter or at
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 28
least understand the norms and attitudes of the group before trying to do specific therapeutic
interventions. This article emphasizes patience on the part of the therapist when trying to
transition a children’s group from their indigenous culture to a therapeutic culture.
Reynolds-Mejia, P., & Levitan, S. (1990). Countertransference issues in the in-home treatment
of child sexual abuse. Child Welfare, LXIX(1), 53-61. Located in Lockwood Memorial Library
at the State University of New York at Buffalo, Amherst campus.
In this article, the impact on therapists working with families dealing with sexual abuse is
discussed. Specifically, working with families is in the home is presented, with the associated
role conflicts and countertransference reactions. Therapist reactions are separated into three
categories: behavioral (overinvolvment, early termination), anxiety (helplessness, boundary
disturbances), and somatic (headaches, panic).
Rosen, R. C., & Hall, K. S. K. (1992). Behavioral treatment approaches for offenders and
victims. In W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical issues,
volume 2 (pp. 301-330).
Hillsdale, NJ: Lawrence Erlbaum Associates.
Book located at
Lockwood Memorial Library at the State University of New York at Buffalo, Amherst campus.
Despite its title, the focus of this chapter is decidedly more geared to treatment of
offenders. Suggestions regarding interventions with offenders and victims are provided, as well
as case examples. The main issues addressed with victims include: anxiety reduction techniques,
an increase in self-esteem and self-efficacy, skills training for appropriate behaviors, and the
encouragement of protective behaviors to reduce the chance of re-victimization.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 29
Salter, A. C. (1992). Epidemiology of child sexual abuse. In W. O’Donohue & J. H. Geer
(Eds.), The sexual abuse of children: Theory and research, volume 1 (pp. 108-138). Hillsdale,
NJ: Lawrence Erlbaum Associates. Book located in the Lockwood Memorial Library at the
State University of New York at Buffalo, Amherst campus.
In the beginning of the chapter, the author quotes a statistic that reports of child sexual
abuse rose over 2000 percent between 1976 and 1986. The remainder of the article is an attempt
by the author to evaluate child sexual abuse research regarding methodology and technique. One
of the issues presented by the author is the problem across all sexual abuse research in defining
sexual abuse in a consistent manner. This lack of consistency makes generalization of results
and general information sharing less possible. Definitional conflicts surround such topics as
contact vs. noncontact, maximum victim age vs. minimum offender age, age discrepancy, and
force vs. no force. At the end of the article, the author returns to the original statistical quote
mentioned in the beginning saying that the true prevalence is unknown, due to a multitude of
complicating factors. Basically, child sexual abuse is considered by this author to be an obvious
and massive social problem that is being inadequately handled.
Schacht, A. J., Kerlinsky, D., & Carlson, C. (1990). Group therapy with sexually abused
boys: Leadership, projective identification, and countertransference issues.
International
Journal of Group Psychotherapy, 40(4), 401-417. Located in Lockwood Memorial Library at
the State University of New York at Buffalo, Amherst campus.
An approach to group psychotherapy with children who have been sexually abused is
presented in this article. The three authors co-facilitated a group with sexually abused or abusing
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 30
boys between the ages of 10 and 14, who were receiving inpatient psychiatric treatment. The
group therapy was only one aspect of the services that were provided to these children. Case
studies of selected participants were also included in the article.
Group time was divided between didactic activities and open discussion of issues. In
terms of goals, the authors focused on the cessation of abusive relationships, as well as increased
self-esteem and trust in others. The first intervention used in the group dealt with stopping abuse
from being continued in the group. This was primarily done through limit-setting and by
labeling behaviors as “abusive” when they occurred in group.
Verbalizing the feelings
associated with the sexual abuse was also considered a priority. Talking about, rather than acting
out, the feelings was the idea behind that goal.
Schamess, G., Streider, F. H., & Connors, K. M. (1997). Supervision and staff training for
children’s group psychotherapy: General principles and applications with cumulatively
traumatized, inner-city children. International Journal of Group Psychotherapy, 47(4), 399-425.
Located in Lockwood Memorial Library at the State University of New York at Buffalo,
Amherst campus.
The importance of modality-specific supervision for therapists conducting children’s
group psychotherapy was discussed in the article. Additionally, an informal survey of 52 child
treatment centers was conducted and showed that less than 30 percent of those centers provided
modality0specific supervision to their group therapist employees and students.
This was
contrasted with 90 percent of those centers providing modality-specific supervision for
individual and family therapists.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 31
Group consultation was recommended for leaders of psychotherapy groups to meet their
unique supervisory needs. Instructions were given on how to establish group consultation in an
agency and what the adverse effects could be for having inappropriate supervision for children’s
group therapists. Two of the reasons presented were group failure and loss of therapist selfconfidence. The stages of group consultation development were then provided, along with
examples of the challenges encountered in each stage.
Also included in the article was a discussion concerning the legitimacy of children’s
group psychotherapy in treating traumatized children. The authors acknowledged the belief by
some clinicians that children’s groups could never be “true” psychotherapy, due to the inclusion
of activities and structure. Documentation of efficacy studies concerning group therapy with
children was also provided.
In this article, the authors report that the ideas promoted reflect “work in progress” at the
Kennedy Krieger Family Center. This program is funded through a grant from the Baltimore
City Department of Social Services. The grant is intended to provide mental health services to
children in foster care and other out-of-home living situations.
Stevenson, J. (1999). The treatment of the long-term sequelae of child abuse. Journal of Child
Psychology and Psychiatry, 40(1), 89-111. Located in Lockwood Memorial Library at the State
University of New York at Buffalo, Amherst campus.
A comprehensive literature review on the consequences of and effective interventions for
child sexual abuse is provided. The author estimates that 12-17% of females and 5-8% of males
will experience sexual abuse. Risk factors for abuse, along with typical prevention efforts, are
discussed, while emphasizing that home visiting is widely accepted as the most effective
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 32
prevention strategy for at-risk children. It is asserted that treatment planning must involve the
assessment of current factors influencing a child’s recovery/coping. Some of the psychological
and behavioral effects of childhood sexual abuse are also provided, which are: decreased IQ,
external locus of control, attachment issues, language delays, social avoidance and aggression,
suicide, alcohol abuse and anxiety disorders. Family and maternal support w are listed as
predictors of improved outcome. Other ideas mentioned were that the effect of psychological
treatment for sexual abuse appears to be “about” equal for children and adults, that a “substantial
minority” of abused children develop no symptoms from the abuse, and that inadequate/poor
parenting can be changed through education.
Sturkie, K. (1992).
Group treatment of child sexual abuse victims: A review.
In W.
O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical issues, volume 2 (pp.
331-364). Hillsdale, NJ: Lawrence Erlbaum Associates. Book located at Lockwood Memorial
Library at the State University of New York at Buffalo, Amherst campus.
This chapter presents an in depth look at group therapy with this population. Rationale
for utilizing this treatment approach is provided, as well as examples of several different group
therapy structures. Advice regarding the selection of group structure, participants, and leaders is
also included. Empirical evidence regarding the efficacy of group therapy is then included with
the discussion divided according to research method employed.
The chapter ends with a
comparison of adolescent and adult group therapy, in terms of group functioning and issues
addressed.
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Bibliography 33
Weille, K. L. H. (1997). The dynamics of sexual victimization/victimizing in the members of a
child sexual abuse group: Exploring the theoretical role of shame. Smith College Studies in
Social Work, 67(2), 225-239. Located in Lockwood Memorial Library at the State University of
New York at Buffalo, Amherst campus.
A structured, group format for working with abused and abusing children is presented in
this article. The author illustrates the connection between those who are abused and those who
abuse as being the shame reaction. Shame is also seen as the link between victimization and
perpetuation, with the author emphasizing the efficacy of dealing with this emotion in a
combined, group setting. Other benefits listed regarding the use of group therapy as a treatment
modality for sexual abuse are the de-stigmatizing aspects of group and improved impulse
control, which is often a by-product of the group experience. The therapy process involved in
the group is also highlighted in the article.
Wolfe, V. V., & Gentile, C. (1992). Psychological assessment of sexually abused children. In
W. O’Donohue & J. H. Greer (Eds.), The sexual abuse of children: Clinical issues, volume 2 (pp.
143-187). Hillsdale, NJ: Lawrence Erlbaum Associates. Book located at Lockwood Memorial
Library at the State University of New York at Buffalo, Amherst campus.
This chapter provides a step-by-step, “how to” guide to information gathering regarding
the child’s history and environment, as well as methods of interviewing the child regarding the
traumatic event. Many different scales are included in the chapter to aid in each step of the
assessment process. The conceptual framework for the assessment is seen as a three part
process: context of the assessment, current psychological adjustment of the child, and mediating
factors regarding the impact of the abuse on the child’s overall well-being. Four types of
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 34
mediating variables were discussed, which were abuse-related factors, child factors, family
variables, and community-related stressors and supports.
Zamanian, K., & Adams, C. (1997).
Group psychotherapy with sexually abused boys:
Dynamics and interventions. International Journal of Group Psychotherapy, 47(1), 109-126.
Located in Lockwood Memorial Library at the State University of New York at Buffalo,
Amherst campus.
A step-by-step example of group psychotherapy with sexually abused boys was provided
in the article. Four boys that were currently living in a residential treatment facility, between the
ages of 5 and 13, were selected for participation in the group. Criteria for selection included
sexual abuse history, at least an average level of intellectual functioning, no psychotic features,
degree of awareness or denial of the abuse, and capacity to participate in group interaction. The
childrens’ level of interest and willingness to attend was also a determining factor.
Case
histories of each of the four participants were provided in the article, as well.
The framework of the group was based on eight goals adopted from the Specialized
Treatment and Rehabilitation Services program in Merceda County, California. Each goal was
presented and discussed in the group for two consecutive sessions. A mixed gender cotherapy
model as also adopted. The article provides examples of the interventions and activities used in
each stage of the group, as well as participant and leader transference/countertransference
reactions. Based on the outcome of the group, the authors recommended long-term therapy for
the children involved. The boys had reportedly developed a better sense of boundaries and the
ability to express themselves openly. However, aggression remained the primary method of
emotional expression and conflict resolution.
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 35
Zivney, O. A., Nash, M. R., & Hulsey, T. L. (1988). Sexual abuse in early versus late
childhood: Differing patterns of pathology as revealed on the Rorschach. Psychopathology,
25(1), 99-106. Located in Lockwood Memorial Library at the State University of New York at
Buffalo, Amherst campus.
The focus of this study was to determine whether or not children abused in early
childhood score differently on the Rorschach than children abused in later childhood. It was
hypothesized that early onset of sexual abuse would create Rorschach responses related to a
“preoedipal pathology”. This pathology was thought to be characterized by conflicts concerning
identity, nurturance, and orality, including perceptual and cognitive deficits. Information from
previously collected psychological reports, Rorschach scores, and social histories was compiled
for 152 female clients of the Dallas Child Guidance Clinic. Participants, between the ages of 9
and 16 at the time of testing, were separated into 3 groups, which were: Early-abuse, Late-abuse,
and Clinic patient controls.
Overall, the rate of abuse, number of perpetrators, and use of force was not significantly
different for early-abuse and late-abuse group members. The duration of abuse was significantly
longer for early-abuse group members, however.
Sample splitting and cross-validation
techniques were used to compare the groups using a predetermined set of four criteria. Through
this procedure, no significant differences were found between Rorschach scores for early-abuse
and clinic patient control group members. Researchers also determined that their hypothesis was
supported by this study, stating that the age at onset of childhood sexual abuse is associated with
the nature of psychological impairment. Simply stated, early-abuse participants showed greater
psychological impairment than those in the late-abuse group. Late-abuse members did not differ
© 2002 CDHS/Research Foundation of SUNY/BSC
Bibliography 36
significantly from the Clinic patient control group members, showing similar Rorschach scores
to Clinic patients in their age range.
© 2002 CDHS/Research Foundation of SUNY/BSC