A combined therapy model (individual and family) for children with sexual behavior problems

This article describes one model from a variety of therapy methods used in the Center for the Prevention and Treatment of Sexual Aggression Among Children. The model combines family and individual therapy for children with sexual behavior problems. The frequency is of two successive individual sessions followed by one family session. The family sessions include the child and both parents, and in some cases siblings are also invited. The article specifies the importance of family therapy for this population and describes the context for appropriate interventions. It gives the characteristics of families whose children are having sexual behavior problems and who are suitable for therapy according to this model. The article deals, among other issues, with the importance of marking boundaries, talking about the fear, restructuring the family and changing behavioral patterns, and recreating communication channels.     

High Conflict Divorce,Violence, and Abuse: Implications for Custody and Visitation Decisions

Today, judges are faced with the daunting task of determining the best interests of the child and making appropriate custody awards to that end. The best interests of children becomes a critical question when domestic violence is involved; yet, determining what constitutes domestic violence is often debated. Research is often divided on what constitutes domestic violence. One body of research focuses on conflict, another focuses on domestic violence. What the first group identifies as intense emotional distress and disagreement, the other identifies as abuse. Judges making custody determinations in such cases are faced with the difficult challenge of distinguishing between a divorce with “high conflict” and a domestic violence case with ongoing abuse. This article will summarize the legal, philosophical, and historical understandings of the “high conflict” family and its potential impact on children. It will also provide practical judicial guidelines for making the important distinction between high conflict and domestic violence and subsequently crafting appropriate and safe child custody awards.     

Psychiatric aspects of sexual abuse

Sexual abuse of children and adolescents has become an increasingly publicized phenomenon. Psychiatrists and other mental health professionals are often called upon to evaluate and treat children and adolescents who may have been sexually abused, to provide counseling or treatment to the families of such children, and to provide reports and testimony for proceedings about such cases in the child protection system, the criminal justice system, and in custody disputes. Clarity regarding the medical, psychiatric, and legal aspects of sexual abuse is essential in carrying out such professional activities and in evaluating and formulating research on sexual abuse. In this paper current knowledge regarding these aspects of sexual abuse is summarized, and the role of psychiatrists in clinical and forensic work involving allegations of sexual abuse is discussed.     

Women who molest children

In only nine of approximately 600 cases of child molestation in New Hampshire and Vermont was the perpetrator found to be a woman. Case histories and some testing data show a history of sexual assault as a child, frequent offense in the company of a dominant male partner, and a major disinhibition as a result of severe character disorder or limited intelligence. These factors not only interfered with maternal bonding and nurturing behavior but also contributed to suspension of judgment about the appropriateness of sexual contact with children.     

Evaluation of a sexual abuse prevention program for preschoolers

Many sexual abuse prevention programs have no research basis to support their claims of effectiveness. The Sexual Abuse Prevention Program for Preschoolers (SAPPP) was developed by modifying a popular prevention program to include behavioral training and rehearsal, and evaluation components. Children were taught to identify different types of touch, to say “no,” and to “tell others.” Each of the six SAPPP lessons included a topic introduction, stories related to the topic, target behavior rehearsal: This was followed by class discussion. Four university preschool children, three females and one male, between the ages of 3 and 4 participated in the program. All of the children showed improvement from pretest to post-test. The improved post-test scores were the result of correct verbal responses. Correct behavior demonstration responses did not increase for any child. A successful child sexual abuse prevention program should train children to demonstrate appropriate preventive behaviors. Suggestions for improving preventive behavior skills demonstrations and increasing the number of children in future research are discussed.     

Homicide and serious sexual offences committed by children and young people: Findings from the literature and a serious case review

This article is based on the findings from a Part 8 Case Review (Serious Case Review) conducted by The Bridge Child Care Development Service, and the subsequent overview report entitled ‘Childhood Lost: A Part 8 Case Review Overview Report DM’ (2001). The review concerns the case of a young male aged 18 (DM) who was convicted for the rape and murder of a child aged 11 (WN). The article highlights the key themes that have emerged from the case review. These include the complex issue of predicting and managing risk; effective inter-agency collaboration in reducing the risk of serious sexual and violent offending in young people; and the provision of specialist residential treatment facilities for serious juvenile sexual offenders. The key issues are located within the broader context of contemporary literature and research. It is established that children and young people who commit homicide and other very serious offences are highly likely to have experienced multiple and severe traumatic events during childhood. In addition without appropriate intervention, children with persistent risk characteristics have a high likelihood of committing further acts of aggression and violence. The review into the case of DM recommends that there should be a national strategy for the management and treatment of serious juvenile sexual offenders, and other young offenders at significant risk of serious and violent offending.     

ANOTHER LOOK AT THE DEVELOPMENTAL RESEARCH

Kelly and Lamb (2000) recently provided a summary of the attachment literature and a set of guidelines for visitation and custody for young children in divorced and separated families. Here, Solomon and Biringen review the same literature with an eye to critically evaluating these guidelines, especially the suggestion that more, rather than fewer, transitions between parents are appropriate for very young children. Three types of empirical findings raise questions regarding the appropriateness of Kelly and Lamb's guidelines. These include differences in the development of infant-mother and infant-father attachments, young children's sensitivity to overnight separations from the primary caregiver, and the possibility of infant preferences for primary versus secondary caregivers in times of stress. The authors argue that considerably more rigorous research is required before submitting Kelly and Lamb's suggestion to social policy.     

Restoring Faith: Resolving the Roman Catholic Church’s Sexual Scandals Through Restorative Justice (Working Paper I)

Two years ago, Independent Academic Research Studies, a UK based international network, started a research and implementation project to explore the potential of restorative justice to help resolve sexual offending cases involving children and young people. One aspect of this project is the use of restorative justice with sexual offending cases that occurred within the Catholic Church. The purpose of this article is to report on the main findings of the first stage of the project, based on desk research into existing or past international projects dealing with the matter. The aim, however, is not to provide a literature review of the main arguments surrounding the topic, but rather a critical overview of the restorative programs and research projects that have been implemented to test the notion’s application in sexual offending cases. The results of these programs will be contrasted with notorious cases that have been processed through the traditional criminal justice system. Therefore, this article is the first in a series on how restorative justice could be applied to help resolve the sexual scandals in the Catholic Church.     

The genuine victim and prosecutors’ charging decisions in sexual assault cases

This study examined the effect of victim characteristics and evidence factors on prosecutors’ decisions to file charges in sexual assault cases. Social scientists and legal scholars argue that sexual assault case processing decisions are affected by stereotypes of real rapes and genuine victims. They assert that complainants whose backgrounds and behavior conform to the image of a genuine victim will be taken more seriously, and their allegations treated more seriously, than complainants whose backgrounds and behavior are at odds with this image. We used a sample of arrests for sexual assault made by the Detroit Police Department in 1989 to test these assertions. We combined six victim characteristics to create a genuine victim scale, and we examined the effect of this scale, as well as a number of evidence factors, on prosecutors’ charging decisions. We performed separate analyses on cases with child victims and cases with adolescent or adult victims. We found that the genuine victim scale did not influence charging decisions in cases with child victims, but was theonly significant predictor in cases involving adolescent or adult victims. In contrast, none of the four evidence factors affected charging in cases with adult victims, and only one of these factors was related to charging in cases involving children. These findings suggest that prosecutors attempt to avoid uncertainty by screening out sexual assault cases unlikely to result in a conviction because of questions about the victim’s character, the victim’s behavior, and the victim’s credibility. This paper is based on work supported by the National Science Foundation under Grant No. SES-9010826. Points of view are those of the authors and do not necessarily represent the position of the National Science Foundataion.     

The children’s programme: a description of a group and family intervention for children engaging in problematic and harmful sexual behaviour and their parents/carers

ABSTRACT

Children under 10 are increasingly being referred to services for concerning problematic or harmful sexual behaviour, but information about interventions to support these children and their families is limited. A 3-year pilot of a group cognitive–behavioural intervention for children and their parents/carers is described. Forty-nine children were referred to the programme with 27 completing the programme in this period. This is the first intervention of its kind to be delivered with a UK population and demographic information is provided about the children who have been assessed, including information about age, gender, family composition and abuse history. Outcome data from the Trauma Symptom Checklist for Children, Child Sexual Behaviour Inventory, Strengths and Difficulties Questionnaire and the Parental Stress and Social Support Scale is reported. The available outcome data indicates the group has been largely beneficial in reducing problematic sexual behaviour. Key learning and implications for practice are discussed.     

Documentation of torture and cruel,inhuman or degrading treatment of children: A review of existing guidelines and tools

The documentation of individual cases of child torture is of paramount importance to bring justice to, and help heal, individuals and sensitize societies. Our objective is to systematically review medical guidelines for the recording of individual cases of child torture or cruel, inhuman or degrading treatment (CIDT). We searched CINAHL, Embase, the Guidelines International Network, Lilacs, Medline, the National Guideline Clearinghouse, PsychInfo and all websites of the organizations participating in the updating of the Istanbul Protocol for guidelines or studies on how to document torture, CIDT or abuse in persons under 18 years. We did not find a comprehensive guideline that encompassed all aspects of the documentation of child torture, as does the Istanbul Protocol for adults. An expert opinion guideline on how to document sexual torture in children was found, and in addition we identified 13 consensus-based guidelines for the evaluation of abuse in children or specific aspects thereof. We strongly recommend a child specific, comprehensive guideline on the documentation of torture and CIDT in children.     

Medical Evidence and Expert Testimony in Child Sexual Abuse

Expert medical testimony in child sexual abuse cases can be critical to the outcome of a legal case. This article will review the development of the medical knowledge and clinical expertise in child sexual abuse. Since the passage of mandatory child abuse reporting laws, the forensic medical examination of a child for evidence of sexual abuse has become standard. Until recently, many myths regarding female genital anatomy existed but were based primarily on dogma and lack of empirical research. Over the past 25 years, many research studies and accumulating clinical evidence have expanded medical knowledge and debunked old myths. Physical evidence, even in cases of alleged genital or anal penetration is rare. Sexually transmitted infections are also uncommon and often require medical interpretation as to their significance in a prepubertal child. Specialized medical knowledge, training, and clinical expertise have developed in order to evaluate children presenting with allegations of sexual abuse. Such medical expertise provides invaluable service to courts. We review criteria for evaluating such expertise in light of current medical practice.     

Juvenile sex offenders: a complex population

Individuals who engage in sexual offending behavior represent a heterogeneous population. Recent research has found some success in categorizing sexual offenders based on a number of variables, particularly the type of victim. For example, differences have been found between those offenders who victimize adults when compared with those who victimize children. However, the research in this area has been conducted predominantly with adult samples. As the adult sex offender literature has progressed, it has become evident that risk assessment, treatment effectiveness, and risk management are dependent on such offender characteristics. Unfortunately, the relevance to juveniles of characteristics deemed to be important with adult sex offenders is limited due to the complexity of developmental processes, particularly with respect to mental disorders and personality formation. As such, the formulation and implementation of treatment and risk management strategies that will be effective with juvenile sex offenders are challenging. The goal of this paper is to review some of the complexities inherent in the juvenile sex offender population by focusing on specific areas of complication, including: classification systems, comorbid paraphilias and other mental illnesses, and maladaptive personality traits.     

Intervention with sexually abusive young people in Australia and New Zealand

Abstract

Research into the treatment of sexual offenders with an intellectual disability has increased over the past decade. This research can be used to investigate the efficacy of treatment; however, empirical limitations of the research make generalizations difficult. Marques has provided a framework for examining treatment efficacy that emphasizes the contribution of researchers and clinicians to report treatment outcomes rather than a strict reliance on rigorous empirical investigations, such as controlled outcome research. This review uses Marques’ framework to present an overview about group treatment for sexual offenders with an intellectual disability using nine identified studies. This paper attempts to consolidate our knowledge about specific treatment issues, while demonstrating the varied outcomes that are reported in the literature. In employing this framework, the literature suggests that our knowledge can be substantially improved by research addressing specific areas of treatment.     

Reforming Relocation Law: An Evidence‐Based Approach

In recent years, there has been much discussion within international fora about the need for a greater consensus on how to approach relocation cases. Empirical research on the lived experience of parents and children who have been through relocation disputes has an important role to play in providing an evidence base for decisions on policy. In this article, we summarize the findings of a 5‐year prospective longitudinal study of relocation disputes in Australia and make recommendations in the light of this and other research evidence concerning a new approach to relocation law. We argue that there should be no presumptions. Nonetheless there is an appropriate place for legislative or appellate guidance on how to approach these disputes. “Good faith” should be irrelevant to decision making, and children should not be placed in the center of the conflict. The adjudication of relocation disputes should be on the basis of asking three questions: First, how close is the relationship between the nonresident parent and the child and how important is that relationship developmentally to the child? Second, if the relocation is to be permitted, how viable are the proposals for contact with the nonresident parent? Third, if the relationship between the child and the nonresident parent is developmentally important to the child and is likely to be diminished if the move is allowed, then (a) what are the viable alternatives to the parents living a long distance apart? and (b) is a move with the primary caregiver the least detrimental alternative?

Key Points for the Family Court Community
• Describes the findings of empirical research on relocation disputes in Australia on the lived experience of children and families postrelocation disputes.
• Reviews various features of relocation law and proposals for reform in the light of this research evidence.
• Proposes an approach to deciding relocation cases based upon three essential questions.

     

The use of multiple informants to assess children's maltreatment experiences

Most researchers rely exclusively on the reports of protective service workers to determine children's abuse history. In this report, information about children's maltreatment experiences is obtained from protective service workers and three supplementary sources of data: parents, medical records, and clinical observations. Fifty-six children from 34 families receiving protective services for verified reports of physical abuse, neglect, sexual abuse, and/or emotional maltreatment participated in the study, with most children known to have experienced more than one type of abuse. The supplementary data provided important information about the range and severity of children's maltreatment experiences. Review of the parent and medical record data led to identification of 28 children who had additional types of maltreatment experiences that were not reported by their protective services workers—nine cases of physical abuse, two cases of neglect, five cases of sexual abuse, and 12 cases of emotional maltreatment. Supplementary data also revealed information about incidents of specific types of abuse that were more severe than those reported by the children's protective service workers in an additional 24 cases. A method was devised to synthesize information provided from the different sources of data examined in this report to derive 0–4 point ratings of four categories of maltreatment experiences: (1) physical abuse, (3) neglect, (3) sexual abuse, and (4) emotional maltreatment. The Kappa reliability coefficients for each of these scales were .88, .73, .83, and .90, respectively. Data demonstrating the relationship between these maltreatment ratings and various indices of the children's socioemotional and cognitive functioning were also presented to provide preliminary support for the validity of these scales. The findings from this study suggest that multiple sources of data should be examined in order to obtain accurate assessments of children's maltreatment experiences, and that independent raters can synthesize discrepant data to obtain reliable and valid estimates of children's abuse history. Clinical and methodological issues relevant to the improved assessment of children's maltreatment experiences are also discussed.     

Children's testimony: Research findings and policy implications

Abstract

Traditionally the British legal system has taken a sceptical attitude toward the testimony of children, reflected in the competency requirement, the corroboration rule and the judicial caution. However, recent psychological research has suggested that children, properly interviewed, can provide invaluable testimony in securing convictions in cases of sexual or physical abuse. Research suggests that children's spontaneous accounts of events are generally accurate, and that suggestibility can be greatly reduced by appropriate questioning techniques. Partly as a result of such research, the legal hurdles surrounding children's evidence have been dismantled and procedural innovations, such as the use of the Videolink and videotaped interviews introduced. Empirical research demonstrates the success of the Videolink and a similar evaluation is planned for videotaped interviews. The latter has highlighted the need for a new research agenda which would include the impact of biased or repeated questioning, and requests to children from abusers to lie or keep secrets.     

CROSSOVER KIDS

This article considers the plight of the child found both abused and delinquent in the American legal system. Discussed in detail are the difficulties attorneys representing these children face, including ethical issues of confidentiality and attorney-client privilege, maintaining a permanent placement for an abused child found delinquent and the paramount importance of determining appropriate jurisdiction. These difficulties are presented through interviews with three children's attorneys who represent abused children and/or delinquent children in Wisconsin, Maryland and Pennsylvania. The article finds that the needs of abused delinquents are not being adequately addressed for a number of reasons. Lack of communication between the two systems and lack of statutory guidelines are both considered and improvements for these issues suggested. Although not directly addressed, the question of whether there is a causal connection between abuse and delinquency is considered in analyzing the techniques and theories of the three interviewed attorneys.     

Do Jurors “Know” What Isn’t So About Child Witnesses?

Are expert witnesses needed in child sexual abuse cases to educate jurors about children’s memory, suggestibility, and reactions to abuse, or do jurors already know what such experts could tell them? To cast light on this question, we surveyed jurors and jury-eligible college students and compared their beliefs with what is known via scientific research regarding children’s memory and ability to testify, reactions to interrogation, and reactions to sexual abuse. We also asked participants to infer results of four widely cited studies of children’s suggestibility. Participants’ beliefs were consistent with findings from research on some issues (e.g., that children can be led to claim that false events occurred) but diverged from the scientific consensus on other issues (e.g., whether children can remember painful events in infancy). Similarly, participants sometimes overestimated and sometimes underestimated the level of suggestibility observed in empirical studies. Individual differences in accuracy were related to participants’ gender, education and ethnicity, and there was considerable disagreement among participants on many questions. Implications of findings for the admissibility of expert testimony in child abuse cases are discussed.     

Judicial Conversations With Children in Parenting Disputes: The Views Of Australian Judges

In an article in the last issue of this Journal, we reportedon a study of parents' and children's views about whether theywould like judges to talk with children in chambers. This articlereports on a related study of the views of Australian judgesconcerning the issue. It explores the reasons that judges gavefor being opposed to or cautiously in favour of having conversationswith children before and after making their decisions. On thebasis of these views, and the views of the parents and childrendiscussed in the earlier article, we propose guidelines on whenand how judges should engage in ‘conversations’with children in chambers if they consider it appropriate todo so.