National survey of professional practice in child sexual abuse

Child Abuse & Neglect, 2015

The purposes of this study were to: (1) Assess child abuse professionals' and nonprofessionals' knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals' levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals' average percent correct, M = 44%, was not significantly different than what would be expected for random guessing (45%). The professionals' average percent correct, M = 55%, was higher than that of nonprofessionals and random guessing (both ps < .001). The average percent correct score for the US-sample psychologists, M = 76%, was higher than the average score of the other professionals, M = 51%, p < .001. Professionals' educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's = .46, p < .001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r = .15, p = .04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.

Journal of Child Sexual Abuse, 2010

In this paper, the concept of expertise as defined in various professions is applied to psychotherapy and more specifically to the field of childhood sexual abuse. Given the dearth of research in this area, exploration of the issue is accompanied by reviewing the curriculum vitae of a number of recognized experts in the field. The paper concludes with a call for the recognition of childhood sexual abuse as a specialized field requiring specialized training both at the graduate level and in continuing postgraduate education.

European Journal of Pediatrics, 2018

Recognizing child sexual abuse (CSA) in children is difficult, as there can be many hurdles in the assessment of alleged CSA. With this paper, we try to improve the recognition of CSA by discussing: (1) the difficulties regarding this matter and (2) the diagnostic evaluation of alleged CSA, combining both practical clinical recommendations based on recent research. Children are restrained to disclose CSA due to various reasons, such as fears, shame, and linguistic or verbal limitations. Associations between CSA and urogenital or gastrointestinal symptoms, internalizing and externalizing behavioral problems, post-traumatic stress symptoms, and atypical sexual behavior in children have been reported. However, these symptoms are non-specific for CSA. The majority of sexually abused children do not display signs of penetrative trauma at anogenital examination. Diagnosing a STI in a child can indicate CSA. However, other transmission routes (e.g., vertical transmission, auto-inoculation) need to be considered as well. Conclusion: The assessment consists of medical interview and child interview (parents and child separate and together) with special attention to the child's development and behavior (problems), psychosocial situation and physical complaints, the child's mental health, and the child's trauma history; anogenital examination should be done in all cases of alleged CSA. The examination should be documented by photo or video graphically. Recent research suggests that videography may be the preferred method, and testing on STIs. The assessment should be done multidisciplinary by experienced professionals. Health-care professionals who care for children need to know how child protective agencies and law enforcement are organized. In case there are concerns about a child's safety, the appropriate authorities should be alarmed. What is Known: • Sexual abuse in children often remains unrecognized in the majority of cases. What is New: • Research suggests that videographic documentation is preferred above photographic documentation for anogenital examination; observations of children's behavioral reactions during examinations might be valuable in the evaluation of suspected sexual abuse; nucleic acid amplification testing can be used on vaginal swabs or urine samples for chlamydia and gonorrhea; the CRIES-13 and the CAPS-CA can be used to assess trauma-symptoms in children after sexual abuse.

The Journal of Psychiatry & Law, 1992

This paper examines controversies between the child-protective and defense-protective positions in the field of child sexual abuse assessments. It argues that the child-protective position is based on valid empirical generalizations that nevertheless can cause injustice because they are mistaken for scientific laws. It argues that the defense-protective position offers important criticisms that nevertheless can cause injustice because they are based on a misunderstanding of the nature of scientific reasoning. Clinical examples of errors in both positions are discussed.

PsycEXTRA Dataset, 2000

This document provides a review of recent, state-of-the-art literature concerning the nature, extent, dynamics, and effects of child sexual abuse and examines America's preventive intervention and treatment efforts for child sexual abuse. After an extensive presentation of the problems of defining terms in sexual abuse, these topics are discussed: (1) scope of the problem, including incidence of abuse; (2) dynamics of sexual abuse, focusing on perpetrators, intrafamilial child sexual abuse, and sexual exploitation; (3) effects of sexual abuse on children and families; (4) prevention education for parents, efforts for professionals, efforts targeted at children, and an evaluation of prevention efforts; (5) intervention; (6) the legal response to child sexual abuse, including statutes and legal intervention; and (7) treatment for victims and offenders. A 226-item reference list and a 30-item selected bibliography are included. (ABL)

Objective: To provide clinicians with current information on prevalence, risk factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To examine the best-documented examples of psychopathology attributable to CSA. Method: Computer literature searches of Medline and PSYCInfo for key words. All English-language articles published after 1989 containing empirical data pertaining to CSA were reviewed. Results: CSA constitutes approximately 10% of officially substantiated child maltreatment cases, numbering approximately 88,000 in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women and men, respectively. Risk factors include gender, age, disabilities, and parental dysfunc-tion. A range of symptoms and disorders has been associated with CSA, but depression in adults and sexualized behaviors in children are the best-documented outcomes. To date, cognitive-behavioral therapy (CBT) of the child and a nonoffending parent is the most effective treatment. Prevention efforts have focused on child education to increase awareness and home visitation to decrease risk factors. Conclusions: CSA is a significant risk factor for psychopathology, especially depression and substance abuse. Preliminary research indicates that CBT is effective for some symptoms, but longitudinal follow-up and large-scale " effectiveness " studies are needed. Prevention programs have promise, but evaluations to date are limited. J. Am. Acad. Child Adolesc. Psychiatry, 2003, 42(3):269–278.

Health & Social Care in …, 1993

The objective of the study described here was to obtain information on the beliefs of professionals concerning possible indicators of a child having been sexually abused. Data were collected by means of selfadministered questionnaires, distributed at meetings on child sexual abuse. The respondents were professionals working in the field of child sexual abuse. Twenty-three social workers, 14 psychologists, 12 nurses, eight medical doctors, including three paediatricians and three psychiatrists, three policemen and two nurses participated. The variables studied were the perceived prevalence of sexual abuse in British children under the age of 10 and the perceived prevalence of various possible signs of sexual abuse in two sub-groups of these children: those who had been sexually abused, and those who had not. The signs investigated were: behavioural problems, somatic complaints, enuresis, chronic urinary infections, fear of toileting, sexualized language, sexualized behaviour, comments suggestive of sexual activity, allegations of sexual abuse, sexually transmitted diseases and reflex anal dilatation.

Ciencia & Saude Coletiva, 2023

Child abuse is a problem that affects children all over the world. The present study therefore aimed to identify and analyze the main findings relating to professional practices for dealing with situations of child maltreatment in articles published in Brazil. To this end, we conducted an integrative literature review of articles published between 2017 and 2022 based on searches of the following databases: Google Scholar, SciELO Brasil, the periodicals database of the Agency for the Improvement of Higher Education Personnel (CAPES), MEDLINE, the Virtual Health Library, and Electronic Journals in Psychology (PePSIC). A total of 24 publications were selected for the review after screening the titles and abstracts. The findings reveal several challenges to ensuring the protection of children caused by shortcomings in professional training, which have a negative influence on the identification and reporting of child maltreatment. The present study reveals the lack of priority given to the issue of child maltreatment in professional training and provides important inputs to inform future research on professional practices for dealing with child violence.

Sexual offending against children remains a socially significant and complex problem. It is becoming increasingly evident that the psychological and emotional costs to victims and their families are profound, with many victims experiencing major difficulties in adjusting to the demands of adult life. In this paper I focus on a number of significant current issues associated with sexual offending and attempt to give a brief overview of these domains: the causes and types of sexual offending; assessment and risk evaluation; the principles of effective intervention; best practice treatment of sexual offenders; and a consideration of treatment effectiveness. I conclude by arguing that we also need to pay more attention to the relationship between normative theories and empirically validated therapeutic techniques. Any understanding of rehabilitation is underpinned by values and assumptions about the kind of lives available to offenders.