Vil Du?! incorporation of a serious game in therapy for sexually abused children and adolescents

Enhancing Child Sexual Abuse Prevention Knowledge With an Educational Toolkit -Evaluation of the Chinese Doll Program

Objective: In countries with conservative attitudes towards sex and limited resources to prevent child sexual abuse, culturally adapted CSA prevention programs are essential. This study outlines a randomized controlled trial evaluating the effectiveness of the Doll program for preventing CSA in the specific context of China. Method: 181 children were pre-tested and post-tested (5 weeks later) for knowledge of sexual abuse prevention. Children were assigned to one of three groups; 1) child only (n = 60); 2) child and parent (n = 60); and 3) control (n = 61). Results: Children in groups 1 and 2 showed significant increases (p < 0.001) in scores on the Appropriate Touch Scale (ATS) and the Inappropriate Touch Scale (ITS), whereas those in the control group did not show a significant increase in ATS scores, but their scores on ITS significantly increased (p < 0.001). Children in group 2 showed significantly increased ITS scores compared to group 1 (p = 0.016). Conclusion: Doll program effectively enhances children's CSA prevention knowledge, with parental engagement demonstrating a positive impact on the program.

Use of technology in evidence-based programs for child maltreatment and its impact on parent and child outcomes

Introduction

Technology has been used in evidence-based child maltreatment (CM) programs for over a decade. Although advancements have been made, the extent of the application of technology in these programs, and its influence on parental and child outcomes, remains unclear within the context of changes that emerged because of the COVID-19 pandemic. This scoping review provides a contextualized overview and summary of the use of technology in evidence-based parenting and child programs serving families impacted by child maltreatment and the effects of technology-enhanced programs on target outcomes.

Materials and methods

Using Arksey and O'Malley's methodological framework, we searched seven databases to identify peer-reviewed and grey literature published in English from 2000 to 2023 on evidence-based programs, according to the California Evidence-Based Clearinghouse (CEBC), that included technological supports for two populations: at-risk parents for child maltreatment prevention, and children and youth 0-18 years exposed to child maltreatment. All study designs were included.

Results

Eight evidence-based parenting programs and one evidence-based child trauma program were identified as using technology across a total of 25 peer-reviewed articles and 2 peer-reviewed abstracts meeting inclusion criteria (n = 19 on parent-level programs; n = 8 on child-level programs). Four studies were published in the context of COVID-19. Two main uses of technology emerged: (1) remote programmatic delivery (i.e., delivering all or part of the program virtually using technology) and (2) programmatic enhancement (i.e., augmenting program content with technology). Improvements across parenting and child mental health and behavioral outcomes were generally observed.

Discussion

Technology use in evidence-based child maltreatment programs is not new; however, the small sample since the start of the COVID-19 pandemic in this review that met inclusion criteria highlight the dearth of research published on the topic. Findings also suggest the need for the inclusion of implementation outcomes related to adoption and engagement, which could inform equitable dissemination and implementation of these programs. Additional considerations for research and practice are discussed.

Digital games and virtual reality applications in child abuse: A scoping review and conceptual framework

Child abuse refers to any form of maltreatment, including physical abuse, sexual abuse, emotional abuse, and neglect that occurs to children under 18 years of age. Digital games and virtual reality (VR) can be used as beneficial solutions for dealing with child maltreatment concerns. This study aimed to present a conceptual framework for showing the applications of these technologies in managing child abuse. The framework is developed in two stages: (1) a scoping review to gather digital games and VR applications for child abuse issues through the search in PubMed, Ovid (APA PsycInfo), Scopus, Web of Science, ProQuest, Institute of Electrical and Electronics Engineers (IEEE), Cochrane Database of Systematic Reviews, and grey literature and (2) developing a conceptual framework based on the review results and validating it by 12 experts. The proposed conceptual framework shows that digital games and VR have been used for six main topics: (1) medical education, (2) prevention, (3) screening, (4) diagnosis, (5) treatment, and (6) forensic medicine in response to child abuse issues. Studies have more focused on child sexual abuse prevention, behavioral monitoring of sexual offenders in forensic medicine, and knowledge or performance assessment of students in medical education. Serious games (SGs), computer simulation, and immersive VR were common technologies for children, students, and forensic medicine, respectively. The experts believe the combination of immersive features of VR with SGs can further encourage user engagement. It appears that digital games and VR can play a positive role in child abuse management. Given the extensive capabilities of these technologies, further studies are needed to show all their potential applications for child abuse problems.

A Therapeutic Game for Sexually Abused Children and Adolescents (Vil Du?!): Exploratory Mixed Methods Evaluation

Background

Talking about experiences of sexual abuse in therapy is difficult for children and adolescents. Possible reasons for this difficulty are a lack of vocabulary to describe the situation or feelings of shame, fear, and self-blame associated with sexual abuse. The serious game Vil Du?! was developed to help children open up about their sexual abuse experiences. Vil Du?! is a nonverbal communication game that resembles a dress-up game in which children can show the therapist what happened to them.

Objective

This exploratory evaluation study examines which working elements of the game could be identified in therapy with victims of sexual abuse (aim 1). In addition, this study examines how therapists evaluate the acceptability of the game (aim 2).

Methods

The therapists completed 23 web-based surveys on the use of Vil Du?! In addition, semistructured interviews were conducted with 10 therapists. The data were analyzed in NVivo following previously reported stepwise guidelines.

Results

Regarding aim 1, therapists mentioned various working elements of Vil Du?!; for instance, Vil Du?! puts the child in control of the situation. In addition, Vil Du?! reduces barriers to disclosure because there is no need to talk or have eye contact with the therapist. Regarding aim 2, Vil Du?! was generally evaluated more positively than negatively by the therapists. For instance, therapists indicated that using Vil Du?! is time efficient and might make the treatment process less confronting and difficult for the client. According to therapists, most clients indeed experienced less tension and more positive (or neutral) emotions than negative emotions when using Vil Du?!

Conclusions

The most important working elements of Vil Du?!, according to therapists, are that it enables children to regain control over their sexual abuse experiences and reduces barriers to disclosing sexual abuse experiences. The more positive evaluation of Vil Du?! indicates the acceptability of the game for therapists as well as their clients.