Filial therapy with parents of chronically ill children.

This study was designed to determine the effectiveness of a 10-wk filial therapy training model as a method of intervention for parents of chronically ill children. 23 parents, with children between the ages of 3 to 10 yrs, were included in the study. Results of the analysis of covariance revealed that parents in the experimental group significantly increased their attitude of acceptance toward their children and significantly reduced their level of stress as compared to parents in the control group. Children in the experimental group scored significantly lower than did children in the control group on total behavioral problems and anxiety and depression. This study supports filial therapy as an effective intervention for parents of chronically ill children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Play therapy behaviors of sexually abused children.

Examined the question of whether there are specific play therapy behaviors associated with children who have been sexually abused, and whether these behaviors differ by sex and age of the children. A survey instrument was developed which listed 140 play therapy behaviors. 21 play therapists participated in a field test to establish external validity. 249 play therapists were also surveyed to identify professionals who provide play therapy. Analysis identified highly interrelated play therapy behaviors of sexually abused girls and boys from ages 3–10 yrs. Suggested use of the play therapy behaviors include assessments to detect sexual abuse and recommendations for child placement and/or court testimony. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy with parents of children experiencing learning difficulties.

The purpose of this study was to determine the effectiveness of a 10 week filial therapy training model as an intervention method for parents of children with learning difficulties. Results of the analysis of covariance revealed that the parents in the experimental group scored significantly higher after training than the parents in the control group on their attitude of acceptance of the child. The experimental group parents attained a significantly lower mean total score on level of stress related to parenting than the control group parents. There was no significant difference between the experimental and control groups' posttest mean scores on the total behavior problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of the MMPI with men who have sexually assaulted children.

Examined the ability of the Minnesota Multiphasic Personality Inventory (MMPI) to describe a sex offender population of 406 men (mean age 35.8 yrs) who had assaulted children and to differentiate this population on the basis of the following offense variables: (1) male vs female minor victimization, (2) nonincestual vs incestual sex offenses, (3) physical vs nonphysical assault methods, (4) rapist vs nonrapist molesters, and (5) assault on younger vs older victims. MMPI Scale 4 (Psychopathic Deviate) and Scale 8 (Schizophrenia) were both significantly elevated in Ss' mean profile. However, contrary to previous studies, no single 2-point MMPI code type was predominant, and two-thirds of the Ss had more than 2 MMPI scale elevations. Some statistically significant differences were found between Ss on Variables 1 and 5, but these differences were not considered to be clinically significant. The limitations of the MMPI in differentiating criminological defined subgroups and variables are discussed. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy: An intervention for parents of children with chronic illness.

Describes the use of filial therapy as an intervention with families of chronically ill children. Filial therapy is an extension of play therapy which uses the behaviors of the client-centered play therapist in a family skills training program. Ss were 5 29–36 yr old mothers of 4.5–8.0 yr old children with chronic illnesses. Parents completed the State–Trait Anxiety Inventory and Parental Acceptance Scale (B. R. Porter, 1952) before and after participating in filial therapy sessions. Children completed the Child Anxiety Scale. Results show that filial therapy can have a positive impact on parents of children with chronic illness. Parents were better able to accurately judge their child's level of anxiety and reported differentiation between themselves and their children. Qualitative reports of outcomes indicate that the parents believed that the course had a positive impact on their relationships with their children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Considerations in the psychoanalytic treatment of men who were sexually abused as children.

Examines the literature on sexually abused men and illustrates with clinical examples from individual and group psychoanalytic practice the themes that emerge in working with them. Sexual abuse situations with boys are considered in 3 groups: those involving penetration, those involving inappropriate tactile contact, and those involving noncontact seduction and excitation. The boundary violation inherent in all of these situations is crucial in the treatment of the man who has been abused, as is the familial context of the abuse. Sexual orientation and gender identity, abuse in a familial context, love and sexuality, and transference and countertransference are discussed. For the analyst treating men who were sexually abused, there may be feelings of being overwhelmed by the seductive energy in the analytic relationship and also wishes to reel back and deny the horror of the material being discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of sexually abused children and adolescents.

The authors review research demonstrating the variable effects of childhood sexual abuse, the need for intervention, and the effectiveness of available treatment models. The well-controlled treatment-outcome studies reviewed do not focus on sensationalistic fringe treatments that treat sexually abused children as a special class of patients. Instead, studies demonstrate empirical evidence for extending and modifying treatment models from mainstream clinical child psychology to sexually abused children. The authors propose a continuum of interventions to meet the needs of this heterogeneous group. Interventions range from psychoeducation, prevention, and screening, to short-term, abuse focused cognitive-behavioral therapy with family involvement, to more comprehensive long-term plans for multiproblem cases. Last discussed are gaps in the research and suggestions for future research to address the pressing dilemmas faced by clinicians and policymakers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer relationships and self-esteem among children who have been maltreated

A prospective longitudinal design was employed to assess risks associated with maltreatment in a representative community sample of 107 maltreated children and an equal number of nonmaltreated comparison children. Heightened difficulties in peer relationships and self-esteem were associated with greater severity and chronicity of maltreatment. For example, children who experienced chronic maltreatment were less well-liked by peers. Type of maltreatment was also related to specific aspects of children's adjustment. For instance, sexual abuse predicted low self-esteem, but not problems in peer relationships. Emotional maltreatment, on the other hand, was related to difficulties in peer relationships, but not to low self-esteem. Thus, the best predictions of specific aspects of children's adjustment were provided by considering timing, type, and severity of maltreatment. For some groups of maltreated children, having a good friend was associated with improvement over time in self-esteem.     

Licensing disciplinary actions for psychologists who have been sexually involved with a client: Some information about offenders.

A search through a large state's psychology-licensing disciplinary records for a 28-mo period identified the 22 cases in which sex with a client had led to disciplining a therapist. Information is presented about offender age, gender, and marital status; for each case, the number of clients involved and whether they were adults or minors are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Course of psychological symptoms in sexually abused young children.

Assessed 8 sexually abused (SA) children (aged 3–7 yrs) repeatedly with the Child Behavior Checklist during a 10–18 mo period to explore the course of psychological symptoms that emerged in response to the abuse. Their individual courses were linked to whether treatment was provided and pathology in the parents. In some Ss, symptoms reflected a similar pattern of resolution. Symptomatology included depression and somatic complaints, aggressiveness, and the emergence of sexualized behavior. Parent–child interactions and the impact of therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study assessing trauma symptoms in sexually abused children engaged in play therapy.

Children who have been sexually abused exhibit a variety of emotional, sexual, behavioral, and psychological problems. A great deal of interest has been generated in the use of play therapy as a clinical approach to intervention with sexually abused children. This study explores the effect of play therapy as a primary treatment modality with sexually abused children. The impact of specific traumatic symptoms and overall treatment is examined. Findings indicate that, overall, trauma symptom severity in children decreased after 6 months of play therapy. In addition, anxiety, depression, post-traumatic stress, and sexual distress scores indicated a significant decrease. Additional research is recommended to develop evaluative and systematic guidelines that will further validate the use of play therapy as an empirically supported assessment and treatment tool. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attribution-based treatment of self-blame and helplessness in sexually abused children.

Reviews a number of attributional distinctions within the concepts of self-blame and helplessness that can be utilized in treatment planning for sexually abused children to make possible simultaneous reduction of guilt and powerlessness. Adaptive and maladaptive subtypes of self-blame and helplessness are separated, often based on their implications for past vs future control. Recommendations are presented for phrasing attributional interventions in language understandable to young children. The formulation is also applied to work on children's ambivalent feelings toward perpetrators and non-offending parents. The role of client education as a therapeutic technique is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with sexual behavior problems in young sexually abused children

OBJECTIVE: To identify variables associated with the presence of sexual behavior problems in young sexually abused children. METHOD: Data were gathered from the clinical records of 100 sexually abused boys and girls ages 3-7 years enrolled in two treatment programs. Information was coded systematically on approximately 350 areas related to the child and family's history and functioning, the sexual abuse experience, and treatment outcome. The children were grouped and compared according to their presenting sexual behavior into three categories: (1) developmentally "expected"; (2) "sexualized/self-focused"; and (3) problematic "interpersonal" sexual behavior. RESULTS: Bivariate and multivariate analyses highlighted five variables which were predictive of sexual behavior problems among sexually abused children. Sexual arousal of the child during his/her sexual abuse, the perpetrator's use of sadism, and a history of physical and emotional abuse differentiated between those children with and without "interpersonal" sexual behavior problems. Who the child blamed for his/her sexual abuse further contributed to the distinction between children whose sexual behavior was exclusively "self-focused" (sexualized) versus "interpersonal." CONCLUSIONS: The five major predictor variables, as well as other variables identified in this study, have potential utility in assessing child risk for negative outcomes and determining referral priorities for sexual abuse treatment. Given that sexual arousal and who the child blames for the abuse are prominent variables associated with sexual problems and self-blame, clinicians will need to ensure that sexually abused children and their caregivers are given specific opportunities to deal with these areas in the supportive context of treatment. Children with sexual behavior problems differ not only in the type and level of sexual behavior they exhibit but in most other areas as well, suggesting a need for differential assessment and individualized treatment approaches.     

Malaise scores in adulthood of children and young people who have been in care

Junctional rhythm is commonly observed during radiofrequency catheter ablation of the fast or slow pathways of atrioventricular nodal reentrant tachycardia (AVNRT). However, the origin of these beats remains unclear. We analyzed the retrograde atrial activation sequence of 16 patients (mean +/- SD: 41.2 +/- 18.9 years old) undergoing catheter ablation for typical AVNRT with detailed catheter mapping of the triangle of Koch. The earliest atrial activations were concordant during tachycardia and junctional rhythm in only 5 of 16 patients. The findings suggest that junctional rhythm is unlikely to represent direct stimulation of the atrioventricular (AV) node via a discrete slow pathway but rather results from enhanced automaticity from > or =1 sites in the AV nodal transitional zone. The ensuing atrial activation pattern results from anisotropic spread from these sites. In addition, these data imply that the original concept of the AV node comprising 2 anatomically defined pathways may not be valid, and that a functionally defined pathway model may be a more accurate representation.     

A comparison of group treatments of women sexually abused as children.

We randomly assigned 65 women who had been sexually abused by a father, stepfather, or other close relative to 1 of 3 treatment conditions: a 10-week interpersonal transaction (IT) group, a 10-week process group, or a wait list condition. Subjects were evaluated at pretreatment, posttreatment, and (if assigned to a group) a 6-month follow-up on measures of social adjustment, depression, fearfulness, and general distress. Results suggested that both the IT and process group formats were more effective than the wait list condition in reducing depression and in alleviating distress; changes were maintained at follow-up. Subjects in the process group format exhibited improvement in social adjustment, whereas subjects in the wait list condition actually deteriorated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame busting: Incorporating group social skills training, shame release and play therapy with a child who was sexually abused.

Describes trauma in children as resulting when a child is exposed to severe physical or sexual abuse and feels betrayed, overwhelmed, and helpless. A case of a 4-yr-old boy with sexualized and aggressive behavior is presented. In this case, a combination approach drawing from different theoretical approaches was used to help the S deal with shame which resulted from the trauma of being sexually abused. Therapeutic emphasis was placed on reducing the internal anger, helplessness and feelings of unworthiness through a weekly social skills training group which emphasized expressing uncomfortable feelings. Individual play therapy incorporated shame reduction techniques developed by the author. A firm classroom structure and insistence on self responsibility along with loving nurturance from teachers helped the child set limits on acting out behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)