NCJ Number
60063
Journal
American Journal of Orthopsychiatry Volume: 29 Issue: 3 Dated: (JULY 1979) Pages: 436-445
Date Published
1979
Length
10 pages
Annotation
A COLLABORATIVE APPROACH TO TREATING SEXUALLY ABUSIVE FAMILIES IS DESCRIBED IN WHICH SUCH FAMILIES ARE VIEWED AS ANALOGOUS TO 'CHARACTER-DISORDERED' INDIVIDUALS.
Abstract
A MODEL FOR THE TREATMENT OF SEXUALLY ABUSIVE FAMILIES WAS DEVELOPED BASED ON THE EXPERIENCE OF AN URBAN INTERAGENCY CHILD ABUSE TEAM INVOLVING A VARIETY OF AGENCIES, INCLUDING WELFARE, POLICE, MEDICAL, AND NURSING SERVICES, SCHOOLS, AND LOCAL MENTAL HEALTH FACILITIES. THIS MODEL, UNLIKE TRADITIONAL VOLUNTARY TREATMENT MODELS, ASSUMES THAT EFFECTIVE INTERVENTION REQUIRES AUTHORITATIVE CONTROL AND CAREFUL COORDINATION OF ALL PROFESSIONAL ACTIVITY. SEXUAL ABUSE IS DEFINED HERE AS ANY SEXUAL MISTREATMENT OF A MINOR CHILD BY PARENT OR GUARDIAN; IT INCLUDES ALL FORMS OF SEXUAL BEHAVIOR FROM FONDLING TO INTERCOURSE. THE SEXUALLY ABUSIVE FAMILY IS VIEWED AS BEING PREDOMINANTLY CHARACTER DISORDERED; THIS HAS MAJOR IMPLICATIONS FOR EFFORTS TO PROVIDE MEANINGFUL CHILD PROTECTION SERVICES AND EFFECTIVE TREATMENT. EFFECTIVELY COORDINATING SERVICES IS CRUCIAL, TOGETHER WITH IMPOSING CRIMINAL CHARGES AND COURT ORDERS PLACING CHILDREN OUTSIDE THE HOME. BEFORE TREATMENT IS INITIATED, A THOROUGH DIAGNOSTIC STUDY OF THE PARENTS INDIVIDUALLY, AS WELL AS THE FAMILY AS A WHOLE, HAS BEEN FOUND USEFUL. THE TREATMENT MODEL CONSISTS OF THREE PHASES. IN THE FIRST PHASE, THE FAMILY IS BROKEN DOWN INTO SMALLER UNITS FOR TREATMENT. THE VICTIM IS INVOLVED IN A GROUP WITH OTHER VICTIMS, AND THE ABUSIVE PARENT AND SPOUSE ARE INVOLVED IN SUITABLE THERAPY. THE ABUSIVE PARENT MIGHT BE PUT IN A BEHAVIOR MODIFICATION REGIME TO CHANGE BASIC SEXUAL ORIENTATION. DURING THIS TIME, THE AUTHORITY OF THE THERAPIST IS BASED ON POSSIBLE OR PENDING COURT ACTION. THE FAMILY IS THEN REUNITED IN THERAPY BUT TYPICALLY NOT UNDER PREEXISTING LIVING CONDITIONS; THAT IS, THE ABUSIVE PARENT DOES NOT RETURN HOME OR THE VICTIM REMAINS IN A FOSTER HOME. USUALLY, BOTH FAMILY AND MARITAL THERAPY ARE PROVIDED OFTEN BY MALE AND FEMALE COTHERAPISTS . TREATMENT AT THIS POINT FOCUSES ON PRODUCING NEW BEHAVIOR AND ON EXPRESSING PAINFUL AND AMBIVALENT FEELINGS. DURING THE FINAL PHASE, FAMILY THERAPY IS CONTINUED AFTER THE MISSING MEMBER RETURNS HOME. THE PURPOSE OF THE CONTINUED THERAPY IS REINFORCEMENT OF NEW ROLES AND ENSURING THAT OLD PATTERNS DO NOT RETURN. TO ILLUSTRATE THE TREATMENT MODEL, A CASE HISTORY IS DESCRIBED. ALTHOUGH THIS TREATMENT MODEL EVOLVED EMPIRICALLY AND APPEARS SUCCESSFUL, IT WOULD BENEFIT FROM FURTHER VALIDATION. REFERENCES ARE INCLUDED. (PRG)