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Schönenberg KH, Glaesmer H, Nesterko Y. [Assessment of the Individual Experience of Sexual Violence in War and Forced Displacement and its Consequences Among Male Victims: A Narrative Literature Review]. Psychother Psychosom Med Psychol 2023; 73:53-61. [PMID: 35793671 DOI: 10.1055/a-1806-3313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
From a psychological perspective, male survivors of sexual violence in the context of war and forced displacement represent a highly burdened population. An adequate assessment of traumatic events and trauma related disorders is often hampered by both disclosure barriers from the patient side as well as by lack of awareness on the part of healthcare professionals regarding male victimization. Based on a narrative literature review, relevant characteristics of violence and their relation to the diagnostic process are elaborated on eight dimensions of individual experience of violence (form of violence, frequency and severity, perpetrator-victim context, societal discrimination, subjective evaluation, concept of masculinity, culture-specific norms, and trauma sequelae). The dimensions are delineated in a case study. In order to thoroughly assess sexualized experiences of violence, there is a need for sensitivity on the part of practitioners to the signs of male victimization and regular assessment of sexualized violence in male patients. In this context, certainty about the confidentiality of the information disclosed and recognition of the injustice are of central importance for those affected. In the long term, the development of specialized support services for male victims is needed.
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Affiliation(s)
- Kim Hella Schönenberg
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Germany
| | - Yuriy Nesterko
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig, Germany
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2
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Jagielski CH, Harer KN. Working with Trauma in the Gastroenterology Setting. Gastroenterol Clin North Am 2022; 51:867-883. [PMID: 36376001 DOI: 10.1016/j.gtc.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients with gastrointestinal (GI) complaints report high rates of previous psychological trauma such as physical, emotional abuse and neglect, sexual trauma, and other traumatic experiences. History of trauma is considered a risk factor for the development of disorders of gut-brain interaction, including irritable bowel syndrome. This article discusses key points for providers in understanding how various aspects of trauma can affect patients' physical and mental health and medical interactions, as well as trauma-informed strategies providers can use to increase patient comfort, improve communication, and improve effectiveness of treatment.
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Affiliation(s)
- Christina H Jagielski
- Division of Gastroenterology and Hepatology, University of Michigan/Michigan Medicine, 1500 East Medical Center Drive, 3912, SPC 5362, Ann Arbor 48109 - 5362, USA.
| | - Kimberly N Harer
- Division of Gastroenterology and Hepatology, University of Michigan/Michigan Medicine, 1500 East Medical Center Drive, 3912, SPC 5362, Ann Arbor 48109 - 5362, USA
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Easton SD, Parchment TM. "The whole wall fell apart, and I felt free for the first time": Men's perceptions of helpful responses during discussion of child sexual abuse. CHILD ABUSE & NEGLECT 2021; 112:104922. [PMID: 33395596 DOI: 10.1016/j.chiabu.2020.104922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is a growing awareness of the prevalence and consequences of childhood sexual abuse (CSA) for boys. Disclosure experiences often impact long-term functioning following CSA. Current understanding around disclosure has evolved from a singular act of telling to a broader, reciprocal process that can include discussion. However, there is limited empirical evidence about what constitutes a helpful response from others during the discussion of CSA for men. OBJECTIVE This study examines the characteristics of a helpful response during the discussion of CSA among a large sample of men with histories of CSA. PARTICIPANTS AND SETTING Participants included 487 men ranging in age from 19 to 84 years (mean = 50.1) who completed an anonymous, one-time online survey as part of a larger project on men's health and well-being. Participants were recruited through research announcements on web sites and discussion boards of national organizations that support adult survivors of CSA. METHODS Narrative data from an open-ended prompt were analyzed using qualitative content and inductive thematic analyses over eleven months. RESULTS The analysis yielded five superordinate themes on men's perceptions of helpful responses from others during discussions of CSA: (1) experience; (2) personal characteristics; (3) specific actions; (4) therapeutic interventions; and (5) insights. CONCLUSIONS Clinicians and health care professionals should convey an awareness of CSA for boys, reach out to men dealing with difficulties tied to early trauma, and implement helpful response strategies in discussions of CSA. Family members, friends, and colleagues within men's social networks can also support recovery with helpful response strategies.
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Affiliation(s)
- Scott D Easton
- Boston College School of Social Work, 140 Commonwealth Avenue, McGuinn Hall, Room 207, Chestnut Hill, MA, 02467, USA.
| | - Tyrone M Parchment
- Boston College School of Social Work, 140 Commonwealth Avenue, McGuinn Hall, Room 135, Chestnut Hill, MA, 02467, USA.
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4
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Kiss L, Quinlan-Davidson M, Pasquero L, Tejero PO, Hogg C, Theis J, Park A, Zimmerman C, Hossain M. Male and LGBT survivors of sexual violence in conflict situations: a realist review of health interventions in low-and middle-income countries. Confl Health 2020; 14:11. [PMID: 32127913 PMCID: PMC7045597 DOI: 10.1186/s13031-020-0254-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/28/2020] [Indexed: 12/18/2022] Open
Abstract
Conflict-related sexual violence (CRSV) against women and girls has been the subject of increasing research and scholarship. Less is known about the health of men, boys and lesbian, gay, bisexual, transgender (LGBT) and other gender non-binary persons who survive CRSV. This paper is the first systematic realist review on medical, mental health and psychosocial support (MHPSS) interventions that focusses on male and LGBT survivors of CRSV. The review explores the gender differences in context, mechanisms and outcomes that underpin interventions addressing the health and psychosocial wellbeing of male and LGBT survivors. The aim is to contribute to the design and delivery of gender-sensitive and, when needed, gender-specific approaches for interventions that respond to specific needs of different groups of all survivors. We conducted a systematic search of academic and grey literature to identify medical and MHPSS interventions that included men, boys and LGBT survivors. We identified interventions specifically targeting women and girls that we used as comparators. We then purposively sampled studies from the fields of gender and health, and sexual abuse against men and LGBT people for theory building and testing. We identified 26 evaluations of interventions for survivors of CRSV. Nine studies included male survivors, twelve studies focussed exclusively on female survivors and one study targeted children and adolescents. No intervention evaluation focussed on LGBT survivors of CRSV. The interventions that included male survivors did not describe specific components for this population. Results of intervention evaluations that included male survivors were not disaggregated by gender, and some studies did not report the gender composition. Although some mental health and psychosocial consequences of sexual violence against men and boys may be similar among male and female survivors, the way each process trauma, display symptoms, seek help, adhere to treatment and improve their mental health differ by gender. Initiatives targeting male and LGBT survivors of CRSV need to be designed to actively address specific gender differences in access, adherence and response to MHPSS interventions. Models of care that are gender-sensitive and integrated to local resources are promising avenues to promote the health of male and LGBT survivors of CRSV.
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Affiliation(s)
- Ligia Kiss
- 1Institute for Global Health, University College London, London, UK
| | | | | | - Patricia Ollé Tejero
- All Survivors Project, Vaduz, Liechtenstein.,3London School of Economics, London, UK
| | - Charu Hogg
- All Survivors Project, Vaduz, Liechtenstein
| | | | | | - Cathy Zimmerman
- 6Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Mazeda Hossain
- 6Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.,7Centre for Women, Peace and Security, London School of Economics, London, UK
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Wark J, Vis JA. Effects of Child Sexual Abuse on the Parenting of Male Survivors. TRAUMA, VIOLENCE & ABUSE 2018; 19:499-511. [PMID: 27770031 DOI: 10.1177/1524838016673600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research shows that child sexual abuse (CSA) can have detrimental effects on adult functioning. While much research regarding the effects of CSA on parenting of mothers is available, there is a dearth of information on how CSA impacts fatherhood. This literature review finds that the parenting experiences of male survivors are characterized by self-perceptions as adequate parents, deficient parenting as measured by standardized instruments, conceptualization of parenting as an intergenerational legacy and potential healing experience, fear of becoming an abuser, and physical and emotional distance from their children. These themes are strongly related to social discourses on intergenerational cycle of violence theories. Fatherhood is not exclusively problematic for male survivors and can be a healing experience and a source of strength for some survivors. Based on literature concerning male survivors who are parents, narrative therapy is recommended as a therapeutic model to explore how fathers who are survivors challenge dominant discourses around legacies of family violence, intergenerational parenting deficiencies, and victimization. Restorying fatherhood as a healing opportunity is essential when working with fathers who are male survivors and their families.
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Affiliation(s)
- Joe Wark
- 1 Kairos Community Resource Centre, Thunder Bay, Ontario, Canada
| | - Jo-Ann Vis
- 2 School of Social Work, Lakehead University, Thunder Bay, Ontario, Canada
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Hendriks B, Vandenberghe AMJA, Peeters L, Roelens K, Keygnaert I. Towards a more integrated and gender-sensitive care delivery for victims of sexual assault: key findings and recommendations from the Belgian sexual assault care centre feasibility study. Int J Equity Health 2018; 17:152. [PMID: 30249254 PMCID: PMC6154874 DOI: 10.1186/s12939-018-0864-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/13/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sexual assault remains a major threat to public health, affecting every gender, gender identity and sexual orientation. Following the Belgian ratification of the Istanbul Convention in 2016, the feasibility of a Belgian sexual assault centre model was investigated, aiming to provide more integrated and patient-centred health and judiciary services to victims of sexual assault. By actively involving health professionals, police and judiciary system representatives, as well as victims themselves, this feasibility study eventually fed into the Belgian Sexual Assault Care Centre model. In this process, this paper assessed current Belgian health services and the degree to which the implementation of this model could contribute to both a more integrated and gender-sensitive care delivery. Findings from this study and the subsequent recommendations aim to contribute to similar reforms in other countries that have already taken or are about to take steps towards an integrated, multi-agency support framework for victims of sexual assault. METHODS A qualitative, descriptive analysis of the survey response of 60 key health professionals (N = 60) representing 15 major Belgian hospitals was first conducted. Comparing their approach with the international guidelines and standards, a Strengths Weaknesses Opportunities and Threats analysis of the current sexual assault health services and their potential transition to the Sexual Assault Care Centre model was then executed. RESULTS Despite adequate equipment, the clear fragmentation of health services and limited follow-up hamper an integrated care delivery in most hospitals. Only three hospitals differentiated their sexual assault care protocol based on the victim's gender, gender identity and sexual orientation. A striking unawareness among health professionals of sexual assault in male victims, as well as in gender and sexual minorities further hampers a gender-sensitive care delivery. CONCLUSIONS The Sexual Assault Care Centre model aims to counter most of the current sexual assault health services' weaknesses and threats hampering an integrated care for victims of sexual assault. Further research and training of health professionals are however required in order to tune this integrated form of care to sexuality and gender-based differences in victims' already multi-faceted healthcare needs.
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Affiliation(s)
- Bavo Hendriks
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Anke Marie-Josée Aimé Vandenberghe
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Laura Peeters
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent University Hospital, Corneel Heymanslaan 10, UZP3, B-9000 Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
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7
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Stephenson LA, Beck K, Busuulwa P, Rosan C, Pariante CM, Pawlby S, Sethna V. Perinatal interventions for mothers and fathers who are survivors of childhood sexual abuse. CHILD ABUSE & NEGLECT 2018; 80:9-31. [PMID: 29558671 DOI: 10.1016/j.chiabu.2018.03.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/04/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
Childhood sexual abuse (CSA) is a worldwide problem with severe long-term consequences. A history of CSA can impact the childbearing experience of mothers and fathers; affecting their mental health, parenting skills and compromising infant development. Nonetheless, the perinatal period offers huge opportunity for intervention and hope. This literature review collates evidence for perinatal psychosocial interventions targeting both mothers and fathers who are survivors of CSA. Publications dating from 1970 to June 2016 were searched using Medline, Maternity and Infant Health, PsychINFO, PsychArticles, PubMed and the International Bibliography of the Social Sciences (IBSS). There were no perinatal interventions that considered the needs of survivor fathers. Sixteen publications on 9 psychosocial perinatal interventions for CSA survivors were identified. However, no sub-analyses specific to CSA survivors were reported. Trauma-specific perinatal interventions drew from a range of theoretical models and varied widely in format. Generally interventions were associated with improvements in maternal mental health, parenting competence, infant attachment security and positive public health outcomes. They were safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocols with adequate fidelity. Yet current data is hampered by small sample size, inconsistent reporting of CSA rates and outcome measures, scarcity of observational data and longer-term follow-up. Intervention modifications are proposed for CSA survivors in view of their unique childbearing experiences.
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Affiliation(s)
- Lucy A Stephenson
- South London and the Maudsley NHS Foundation Trust/Institute Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Katherine Beck
- Department of Psychosis Studies, Institute Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Paula Busuulwa
- GKT School of Medical Education, King's College London, UK
| | - Camilla Rosan
- National Society for the Prevention of Cruelty to Children, UK
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Lab. & Perinatal Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Susan Pawlby
- Stress, Psychiatry and Immunology Lab. & Perinatal Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Vaheshta Sethna
- Stress, Psychiatry and Immunology Lab. & Perinatal Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
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8
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Graves EG, Borders LD, Ackerman TA. Resilience to Child Sexual Abuse in Male College Students. ACTA ACUST UNITED AC 2017. [DOI: 10.17744/mehc.39.2.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little is known about men's experiences in the aftermath of child sexual abuse (CSA). Consistent themes from qualitative studies were operationalized and tested for their impact on resilience. For the sample of college-enrolled men (n = 55), the themes of mattering and of traditional male attitudes were not related to resilience, but the theme of gender self-acceptance significantly predicted 23% of the variance in resilience scores. Importantly, the men's perceptions of the CSA events they experienced, whether they described these events as abusive or consensual, were not related to the men's resilience scores. The results indicated that effective counseling approaches to support men's recovery processes differ from those supporting women's recovery. These results suggest that mental health counselors should focus on encouraging male survivors' gender self-acceptance, exploring what it means to be a man in modern society, and examining points of connection with and disconnection from that cultural portrayal.
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9
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Chan TMS, Teram E, Shaw I. Balancing Methodological Rigor and the Needs of Research Participants: A Debate on Alternative Approaches to Sensitive Research. QUALITATIVE HEALTH RESEARCH 2017; 27:260-270. [PMID: 26386026 DOI: 10.1177/1049732315605272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite growing consideration of the needs of research participants in studies related to sensitive issues, discussions of alternative ways to design sensitive research are scarce. Structured as an exchange between two researchers who used different approaches in their studies with childhood sexual abuse survivors, in this article, we seek to advance understanding of methodological and ethical issues in designing sensitive research. The first perspective, which is termed protective, promotes the gradual progression of participants from a treatment phase into a research phase, with the ongoing presence of a researcher and a social worker in both phases. In the second perspective, which is termed minimalist, we argue for clear boundaries between research and treatment processes, limiting the responsibility of researchers to ensuring that professional support is available to participants who experience emotional difficulties. Following rebuttals, lessons are drawn for ethical balancing between methodological rigor and the needs of participants.
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Affiliation(s)
- T M Simon Chan
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Eli Teram
- Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ian Shaw
- Aalborg Universitet, Aalborg, Denmark
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10
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Thomas SP, Phillips KD, Blaine SK. Psychotherapy Experiences of Perpetrators of Child Sexual Abuse. Arch Psychiatr Nurs 2015; 29:309-15. [PMID: 26397434 DOI: 10.1016/j.apnu.2015.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/23/2015] [Accepted: 05/27/2015] [Indexed: 11/25/2022]
Abstract
Cynicism about treatment of sex offenders pervades both professional and lay literature. A Cochrane review of randomized controlled trials concluded there is no evidence to support any psychological intervention for sex offenders, but RCT design has limitations for evaluating sex offender treatment. Rarely has a qualitative approach been used to explore perceptions of offenders themselves about their psychotherapy experiences. The purpose of this study was to discover the meaning of therapy experiences to 11 community-dwelling perpetrators of child sexual abuse. They had received therapy during incarceration or after release, or both. Secondary analysis was conducted of phenomenological interviews about participants' early life, during which they spontaneously revealed insights gleaned during therapy in adulthood. Rigor of the analysis was enhanced by reading transcripts aloud and thematizing them in an interdisciplinary interpretive group. Five interrelated themes constituted a gestalt comprising the essence of the therapy experience: "This treatment, it's just totally changed my whole world." Themes included: "It just stripped away all the pretense, all the lies, all the manipulation;" "I didn't understand myself; I found out all about myself through this;" "Nobody knew any of my secrets; that (therapy) was the first time that I got to tell my story;" "The group has become a family for me;" and "I'm very ashamed of what I've done; this treatment has really helped me, gave me a second chance." These findings stand in contrast to cynicism about sex offender therapy and lend support to the increased optimism expressed by several contemporary scholars.
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11
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Gallo-Silver L, Anderson CM, Romo J. Best clinical practices for male adult survivors of childhood sexual abuse: "do no harm". Perm J 2015; 18:82-7. [PMID: 25106042 DOI: 10.7812/tpp/14-009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in communication, locus of control, and consent/permission before and during physical examinations and procedures. The intent of this article is to act as a catalyst for improved patient care and more research focused on the identification and optimal responses to the needs of men with adverse childhood experiences in the health care setting.
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Affiliation(s)
- Les Gallo-Silver
- Associate Professor of Health Sciences at LaGuardia Community College of the City University of New York, in Long Island City.
| | | | - Jaime Romo
- Commissioned Minister in the United Church of Christ for Healing and Healthy Environments in Carlsbad, CA,
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12
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Abstract
Patients with a history of traumatic life events can become distressed or re-traumatized as the result of healthcare experiences. These patients can benefit from trauma-informed care that is sensitive to their unique needs. However, despite the widespread prevalence of traumatic life experiences such as sexual assault and intimate partner violence, trauma-informed care has not been widely researched or implemented. The purpose of this synthesis of the literature is to examine existing research on trauma-informed care for survivors of physical and sexual abuse. The following themes are discussed: trauma screening and patient disclosure, provider-patient relationships, minimizing distress and maximizing autonomy, multidisciplinary collaboration and referrals, and trauma-informed care in diverse settings. This synthesis also explores implications for trauma-informed care research, practice and policy. The themes identified here could be used as a framework for creating provider and survivor educational interventions and for implementing trauma-informed care across disciplines. The findings of this synthesis support further research on patient and provider experiences of trauma-informed care, and research to test the efficacy of trauma-informed care interventions across healthcare settings. Universal implementation of trauma-informed care can ensure that the unique needs of trauma survivors as patients are met, and mitigate barriers to care and health disparities experienced by this vulnerable population.
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Affiliation(s)
- Elizabeth Reeves
- a Duke University, School of Nursing , Durham , North Carolina , USA
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Sanford A, Donahue M, Cosden M. Consumer perceptions of trauma assessment and intervention in substance abuse treatment. J Subst Abuse Treat 2014; 47:233-8. [PMID: 25012556 DOI: 10.1016/j.jsat.2014.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/06/2014] [Accepted: 05/12/2014] [Indexed: 11/17/2022]
Abstract
Substance abuse treatment programs are increasing their use of integrated interventions for trauma and substance abuse. While positive behavioral outcomes have been associated with this model, the purpose of this study was to determine consumers' satisfaction with it. Participants were 51 men and 102 women who received trauma assessments and interventions through a drug treatment court. Satisfaction with treatment was measured through the Consumer Perception of Care (CPC). Participants were generally satisfied with the trauma assessments and interventions they received. Number of traumatic experiences, measured by the Adverse Childhood Experiences (ACE) scale, and level of distress, as assessed on the Trauma Symptom Inventory (TSI), were significantly associated with assessment and treatment satisfaction. Gender differences were noted, with men reporting fewer traumatic experiences and trauma-symptoms and less satisfaction with trauma assessment. Implications for the integration of trauma and substance abuse interventions in drug treatment courts and other programs are discussed.
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Affiliation(s)
| | - Megan Donahue
- University of California, Santa Barbara, United States
| | - Merith Cosden
- University of California, Santa Barbara, United States.
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14
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Lev-Wiesel R, Gottfried R, Eisikovits Z, First M. Factors affecting disclosure among Israeli children in residential care due to domestic violence. CHILD ABUSE & NEGLECT 2014; 38:618-626. [PMID: 24631415 DOI: 10.1016/j.chiabu.2014.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 01/25/2014] [Accepted: 02/02/2014] [Indexed: 06/03/2023]
Abstract
Disclosure of child abuse may enable initiating interventions to end maltreatment and mediate its negative physical and psychological consequences. The present study reviews the field of disclosure and examines factors affecting disclosure among a service population of abused children who were placed in residential care due to various forms of abuse (e.g., physical, sexual, emotional, neglect and witnessing domestic violence). The sample consisted of 286 Israeli (Hebrew and Arabic speaking) children aged 12-17 (mean=14±1). Following approval of the Ethics committee of the University and parents' written consent, participants were administered a self-report questionnaire that included the following measures: a Socio-Demographic Questionnaire, the Childhood Trauma Questionnaire (CTQ), the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Results indicated that the three key factors enhancing the likelihood of disclosure were: moral factors, external initiatives and intolerable physical pain. The three key factors inhibiting disclosure were feelings of shame, fear of losing social support and uncertainty as to how and to whom to disclose. Results also showed that children preferred to disclose to their nuclear family members (parents and siblings) in comparison with professionals.
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Affiliation(s)
- Rachel Lev-Wiesel
- Faculty of Social Welfare and Health Sciences, University of Haifa, Aba-Hushi Avenue, Mount Carmel, 3478601 Haifa, Israel
| | - Ruth Gottfried
- Faculty of Social Welfare and Health Sciences, University of Haifa, Aba-Hushi Avenue, Mount Carmel, 3478601 Haifa, Israel
| | - Zvi Eisikovits
- Faculty of Social Welfare and Health Sciences, University of Haifa, Aba-Hushi Avenue, Mount Carmel, 3478601 Haifa, Israel
| | - Maya First
- Faculty of Social Welfare and Health Sciences, University of Haifa, Aba-Hushi Avenue, Mount Carmel, 3478601 Haifa, Israel
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15
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Walker J, Allan HT. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients? J Clin Nurs 2013; 23:1857-65. [PMID: 24942268 DOI: 10.1111/jocn.12390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the training needs and awareness of childhood sexual abuse amongst clinical staff taking cervical screening samples in one inner city primary care trust. BACKGROUND Studies exploring sexual abuse and nonparticipation in cervical screening have demonstrated that women can experience re-traumatisation if care during examinations is insensitive to their particular needs. DESIGN This was a mixed methods, service evaluation in three phases. METHODS A literature review, a questionnaire to cervical screening staff in an inner city primary care trust and a focus group of four staff drawn from questionnaire respondents to explore themes raised in the questionnaire data. RESULTS Data analysis of both quantitative and qualitative data showed that clinical staff underestimated the frequency of childhood sexual abuse although they were aware of the difficulties and reluctance some women experience undergoing gynaecological examinations. When women did disclose childhood sexual abuse or when staff suspected a history of childhood sexual abuse, staff reported feeling unsure of how they should proceed. There was no support or clinical supervision, and unmet training needs were identified. CONCLUSIONS Nurses expressed anxiety around the potential of the screening test to cause more harm than good and at their inability to provide more help than listening. Staff wanted support and further training after completing their cervical screening training course to assist in their provision of sensitive care to patients who have experienced childhood sexual abuse. RELEVANCE TO CLINICAL PRACTICE Whilst our results cannot be generalised to a wider population, they may be meaningful for the community of cervical screening takers. We argue that screening staff require further training and professional support (clinical supervision) to increase their confidence when providing safe and sensitive practice for childhood sexual abuse survivors. If staff feel more confident and competent when responding to disclosure of childhood sexual abuse in screening situations, women who have experienced childhood sexual abuse might participate in the screening programme more readily.
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Chernomas WM, Mordoch E. Nurses' perspectives on the care of adults with mental health problems and histories of childhood sexual abuse. Issues Ment Health Nurs 2013; 34:639-47. [PMID: 24004357 DOI: 10.3109/01612840.2013.799721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite growing awareness and evidence linking childhood sexual abuse (CSA) to numerous ongoing health problems in adulthood, the integration of this knowledge into nursing practice remains inconsistent. This article reports the results of a study that explored nurses' perspectives on, and experiences with, providing care for adults with mental health problems who may also have histories of CSA. Nurses' views underscore the challenges and complexities involved when providing care for this population. The themes of nurses' knowledge and comfort levels, ethical practice, patient care considerations, and system issues are used to discuss nurses' understandings, perspectives, and experiences.
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Hovey A, Stalker CA, Schachter CL, Teram E, Lasiuk G. Practical ways psychotherapy can support physical healthcare experiences for male survivors of childhood sexual abuse. JOURNAL OF CHILD SEXUAL ABUSE 2011; 20:37-57. [PMID: 21259146 DOI: 10.1080/10538712.2011.539963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse (Schachter, Stalker, Teram, Lasiuk, & Danilkewich, 2009), which is intended to help healthcare providers from all disciplines understand the effect of child sexual abuse on some survivors' abilities to access and benefit from health care. This paper discusses what psychotherapists can learn from the healthcare experiences of the male survivors who participated in this project. It also offers practical suggestions for supporting male clients who experience difficulty seeking treatment for physical health concerns.
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Affiliation(s)
- Angela Hovey
- Wilfrid Laurier University, Waterloo, Ontario, Canada.
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Priebe G, Svedin CG. Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents' disclosures. CHILD ABUSE & NEGLECT 2008; 32:1095-1108. [PMID: 19038448 DOI: 10.1016/j.chiabu.2008.04.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 04/01/2008] [Accepted: 04/17/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVES The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse. METHOD A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning sexual experiences in this study with a focus on disclosure of sexual abuse (non-contact, contact or penetrating abuse, and including peer abuse). RESULTS Of the sample, 1,505 girls (65%) and 457 boys (23%) reported experience of sexual abuse. The disclosure rate was 81% (girls) and 69% (boys). Girls and boys disclosed most often to a friend of their own age. Few had disclosed to professionals. Even fewer said that the incident had been reported to the authorities. Logistic regression showed that it was less likely for girls to disclose if they had experienced contact sexual abuse with or without penetration, abuse by a family member, only a single abuse occasion or if they had perceived their parents as non-caring. Boys were less likely to disclose if they studied a vocational program, lived with both parents or had perceived their parents as either caring and overprotective or non-caring and not overprotective. CONCLUSIONS Disclosing sexual abuse is a complex process. Much is hidden from the adult society, especially from professionals and the legal system. Since peers are the most common receivers of abuse information, programs for supporting peers ought to be developed. Differences in disclosure patterns for girls and boys indicate that a gender perspective is helpful when developing guidelines for professionals. PRACTICE IMPLICATIONS Professionals, especially in the school system, need to be more aware of the finding that few sexually abused children seek help from professionals or other adults and that support offers should be directly addressed not only to the vulnerable young persons themselves but also to peers who wish to help a friend.
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Affiliation(s)
- Gisela Priebe
- Department of Child and Adolescent Psychiatry, IKVL, Lund University, Sofiavägen 2 D, S-221 41 Lund, Sweden
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Havig K. The health care experiences of adult survivors of child sexual abuse: a systematic review of evidence on sensitive practice. TRAUMA, VIOLENCE & ABUSE 2008; 9:19-33. [PMID: 18182629 DOI: 10.1177/1524838007309805] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This systematic review analyzes empirically based medical literature relevant to the experiences of adult survivors of sexual abuse in the health care setting and what is known about providing sensitive care to this population. Effects of this trauma may impact the adult survivor's experience of care, health behaviors, and outcomes. The 10 articles reviewed in this study provide patient-based information on the experience of child sexual abuse and its impact on health and health care for patients. Suggestions are made for health care providers in two main areas: facilitation of communication and disclosure issues, and improving the experience of the health care encounter for survivors. Specific strategies are offered to assist in providing nonthreatening care encounters for adults who have been affected by childhood sexual trauma. Implications for research, practice, and policy for patients, health care providers, and social workers in the health care setting are discussed.
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Affiliation(s)
- Kirsten Havig
- University of Missouri--Columbia School of Social Work, USA
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