Variables Associated With Positive Outcomes

VARIABLES ASSOCIATED WITH POSITIVE TREATMENT OUTCOMES

FOR CHILDREN SURVIVING SEXUAL ABUSE

Michael V. Merrick

Betsy Morrison Allen

Sedahlia Jasper Crase

This exploratory study examined variables associated with positive treatment outcomes (treatment objectives accomplished and positive placement outcome)for children surviving sexual abuse. A higher percentage of treatment objectives that were accomplished was significantly correlated with a positive placement outcome.

Treatment objectives identified include:

child is able to define sexual abuse, assert right to say "no", avoid vulnerable situations, and is likely to tell if abuse is encoutered again;

child recognizes and believes that (s)he is not responsible for the sexual abuse;

child has been able to disclose details and feelings associated with the sexual abuse to at least one other significant person;

child is experiencing decrease in nightmares or flashbacks pertaining to the sexual abuse;

child is exhibiting decrease in frequency/intensity of aggressive/destructive/self-destructive behavior resulting from sexual abuse;

child is exhibiting decrease in frequency/intensity of sexually acting out behaviors;

child is able to name at least three people outside family system whom (s)he can trust and would disclose to if sexually abused again;

child is able to make positive statements about his/her self-concept; and

child is able to demonstrate appropriate expressions of affection to important people in his/her life.

Positive placement outcome was defined as a child residing in the same or a less restrictive place of care. For example if a child was at home and remained at home, or a child was in family foster care and returned home, this was viewed as a positive placement outcome. A negative placement outcome was defined as a child residing in a more restrictive place of care or who was on run at the time that sexual abuse treatment services were terminated.

Variables associated with a higher percentage of treatment objectives being accomplished include:

services provided to pre-adolescent child;

child resided at home during treatment;

perpetrator was criminally charged;

support by non-offending caretaker at disclosure and at time of treatment;

individual, family, and group therapy were provided; and

termination of services was planned.

Variables associated with a positive placement outcome include:

services provided to pre-adolescent child;

abuse did not involve body penetration;

child resided at home during treatment;

child was never removed from home prior to treatment;

services were voluntary and not court-ordered; and

termination of services was planned.

Discussion

Early intervention is associated with a positive prognosis.

The existance of a significant caretaker who is supportive and protective in the family system appears to be extremely important in the prognosis of positive treatment outcomes for children surviving sexual abuse

Children who are able to stay at home and receive in-home or outpatient services had a much better prognosis of surviving sexual abuse constructively.

Effective treatment needs to consider the child's perception, reactions and resources of family members, and the dynamics of the sexual abuse and aftermath.

Reference:

Merrick, MV, Allen, BM, and Crase, SJ. (1994). Variables Associated With Positive Treatment Outcomes For Children Suirviving Sexual Abuse. Journal of Child Sexual Abuse, 3(2), 67-87.