Validating the Effectiveness of Participation in a Time-Sensitive Closed Therapeutic Group for Preschool Aged Children Allegedly Sexually Abused
This paper will review existing research on allegedly sexually abused preschool aged children. The traumatic psychological effects of the abuse including low self-esteem, poor peer relationships, behavior problems, cognitive functioning and physical/mental health will also be evaluated.
The author notes the paucity of available material on sexually abused children. Very little therefore is known of the effectiveness of psychotherapy to assist in the treatment of the problems of this particular group of abused children - a population of 40 selected children with a mean age of 45, with their parents (either father or mother) and/or caregivers attending sessions in another session hall at the same time the children are undergoing therapy.
This proposed study will therefore focus on how mental health services are provided to preschool children with ages ranging between 4 and 6 who have been allegedly sexually abused and the extent to which poor social skills and low self-concept affect this population.
The sample will be from Bethesda Alternative, a non-profit agency in Norman that specializes in the treatment of sexually abused children, their non-offending caretakers, and the suspected perpetrators of sexual crimes against children.
The information acquired will be integrated into sexual abuse literature and provide additional insight into the delivery of mental health services to the allegedly sexually abused preschool children.
Childhood sexual abuse is one of society's major problems today. It is not germane to a particular race, gender, age or socioeconomic status. In far too many cases, it will be noted that children who were sexually abused in their early years identify with the abusers and become abusers in themselves in later years. They also indulge in many deviant behavior. The effects of childhood sexual abuse are thus magnified as more adults disclose an early sexual abuse history.
Because of these disclosures, concerned educators, policy makers, psychiatrists, clinicians, nurses, guidance counselors and religious groups have agitated for an effective treatment for sexually abused children. This is clearly an indication of the need for the problem to be addressed in a more dynamic, more effective and more thorough fashion.
What indeed is childhood sexual abuse? In this paper childhood sexual abuse will be defined as any "forced or coerced sexual action or behavior imposed on a child or any sexual activity between a child and a much older person whether or not obvious coercion is involved."
The sexual behavior may include non-contact abuse, including exposing the child to indecent suggestions and exhibitionisms and/or contact abuse, including any sexual touching, genital contact, involving either the perpetrators or victim's genitals and/or abuse involving actual penetration." It may also mean inappropriate sexualized behavior, sexually acting out, characterized by a feeling of low self-esteem, and regressive behavior in the child victim.
Because of the increased number of sexual abuse cases among preschool aged children, clinicians, teachers, parents, school programs are intensifying and expanding their activities and capabilities to address this issue.
There is empirical evidence that the rate of spontaneous recovery is high following the disclosure of sexual abuse. (Benther Williams and Zetzer, 1994) although other authorities dispute this recovery frequency (Adams, Tucker, 1984).
Results are often described as having consequences that can be felt throughout an individual's life (Newberger and Devos, 1988). The validity of current treatments need to be established.
Depending on the criteria used, the prevalence of sexual abuses ranges from 150,000 to 200,000 cases reported per year (Reid-Alter, Gibbs, Lachenmeyer, Sigal and Massoth, 1996). Treatments tend to focus on the negative behavior of the sexually abused child. Major treatment modalities used for the sexually abused child include cognitive behavior therapy, psychodynamic therapy, play therapy and various allied therapies. These common treatments attempted to reduce negative behaviors and assist the child to relive the experience in a supportive environment. These interventions however fail to treat concomitant deficits associated with the effects of sexual abuse on the preschooler. The so-termed co-marked deficits include low self-esteem, inadequate special skills, labile mood, limited frustration tolerance, temper, tantrums and outbursts, chronic school failure and academic underachievement that often results in an emotional and behavioral disorder (EBD) label. Evaluative reports on treatments for sexual abuse among preschool aged children have focused on the aforementioned treatment modalities associated with the individual experience.
Research studies related to sexual abuse make extensive references to the difficulties faced by preschool aged children who have allegedly been sexually abused. Children who have been sexually abused tend to suffer from low self-esteem, have difficulty with impulse control issues and have difficulty developing poor relationships.
Similarly psychotherapy has been found effective in the treatment of low self-esteem, impulse control and poor peer relationships. In contrast, there is very little research material in psychology on the treatment of children, specifically pre-school-aged who have been allegedly sexually abused. This in spite of the fact that psychotherapy has been found effective in intervention modalities. There is very little available research on how mental health treatment is provided to preschool aged children.
Purpose of the Study
It is the purpose of this study to evaluate the effectiveness of a structured, time sensitive, closed therapeutic program for allegedly sexually abused pre-school children whose median age is five years. Despite the psychological aspects of the problem, there is no treatment study which has been conducted which evaluated the effectiveness of the therapy which has been applied to this particular population of preschool children allegedly sexually abused. This study therefore is intended to provide the preliminary investigation concerning the delivery of mental health services to a structured, closed, time sensitive preschool-aged group and the benefits of psychotherapeutic treatment for low self-esteem, impulse control and poor peer treatments.
Statement of the Problem
What is the nature and process of mental health counseling for preschool aged children who have been allegedly sexually abused? What behavioral changes occurred in the children upon completion of the structured, time sensitive, closed therapeutic program?
The independent variables will be measured by changes in social skills, self-esteem, impulse control and sexualized behavior.
An empirical analysis will be used by the researcher to describe the nature and process of the counseling mental health program. She will describe in detail each aspect of change in behavior in each of the 40 child participants in the program. A description of the sessions held for parents/caregivers will also be done by this researcher and the corresponding assessment will be included.
A structured interview will be presented and analyzed to determine the appropriateness for participation in the program.
To validate the effectiveness of the VOCA-funded mental health therapeutic program, the researcher proposes to use the Chi Square -Multiple Samples method.
REVIEW OF RELATED LITERATURE
When a child acts in a disorderly, disconnected manner, his nervous force is under a great strain." (Montessori, 1949 p. 64)
Over the years, Maria Montessori has studied children, observed them, cared for them, formulated ways by which they can best learn skills and enhance them. When the children's actions and attitudes are discordant, when he is confused, disoriented, when he doesn't know what to do, then he is laboring under great stress and his parents, caregivers, teachers must try to ferret out the reasons behind the unseemly, unusual actions and attitudes and institute ways by which he can be brought back to normalcy.
More often than not, the uncoordinated child has been traumatized by an event or incident he is powerless to cope with. The parent/caregiver/teacher/clinician should provide a framework to better recognize and manage this impact of a traumatic incident or event.
Marsha L. Shelov (Children and Trauma; the Role of Parents) thinks that a very important point to consider is how we can identify children who have actually experienced such a trauma. For her a traumatic situation "occurs when sudden or extraordinary external event over-whelms a child's capacity to cope, producing the inability to master or control the feelings caused by the event. The condition in which the child is exposed to a terrifying event either as a victim or a witness can cause intense feelings of fear and helplessness, an emotional terror. The trauma may be a one-time event or the result of a repeated exposure to traumatic stressors.
Sexual abuse is an example of a traumatic experience. The child's mind become flooded with impressions of both the attacker's aggression and the anguish of the victim's emotional and physical suffering. The severity, duration and proximity of an individual's exposure to the traumatic event are the most important factors affecting the child's experience of the event.
Children's responses to trauma:
According to Shelov, "the first reaction of the child is often an increased sense of fear of further immediate trauma and thus the loss of a child's usual sense of immunity to such danger. Instead of facing life with a typical sense of openness, a traumatized child may retreat defensively. Mild or severe, a traumatically frightening experience matters deeply to a child and even when the…