Rape treatment outcome research: empirical findings and state of the literature

Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length

BACKGROUND

Child sexual abuse (CSA) is associated with the development of a variety of mental health disorders, and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an established treatment for children who have experienced CSA. However, there are questions about how many TF-CBT sessions should be delivered to achieve clinical efficacy and whether a trauma narrative (TN) component is essential. This study examined the differential effects of TF-CBT with or without the TN component in 8 versus 16 sessions.

METHODS

Two hundred and ten children (aged 4-11 years) referred for CSA and posttraumatic stress disorder symptoms were randomly assigned to one of the four treatment conditions: 8 sessions with no TN, 8 sessions with TN, 16 sessions with no TN, and 16 sessions with TN.

RESULTS

Mixed-model ANCOVAs demonstrated that significant posttreatment improvements had occurred with respect to 14 outcome measures across all conditions. Significant main and interactive effect differences were found across conditions with respect to specific outcomes.

CONCLUSIONS

TF-CBT, regardless of the number of sessions or the inclusion of a TN component, was effective in improving participant symptomatology as well as parenting skills and the children's personal safety skills. The eight session condition that included the TN component seemed to be the most effective and efficient means of ameliorating parents' abuse-specific distress as well as children's abuse-related fear and general anxiety. On the other hand, parents assigned to the 16 session, no narrative condition reported greater increases in effective parenting practices and fewer externalizing child behavioral problems at posttreatment.

Intellectually disabled rape survivors' perceptions of morality and consequences of the crime

Of 135 intellectually disabled rape survivors who were given forensic psychological examinations, 82.2% perceived the perpetrators' actions as wrong, 2 (1.5%) did not think it was wrong, and 22 (16.3%) could not articulate if it was wrong or not. 52.6% cited personal nonconsent as the reason for believing it was wrong, 11.1% cited the pain or injury suffered, 8.9% perceived the act as a broader moral wrong, and 27.4% could not elucidate reasons or did not think it was wrong. 76.3% wanted the perpetrators to be imprisoned, while 23.7% were unable to formulate an opinion on consequences for the perpetrator. The results contribute to a fuller understanding of intellectually disabled rape survivors' perceptions of the criminal act and their rights to demand justice.

Sexual violence: psychiatric healing with eye movement reprocessing and desensitization

Sexual violence, which affects one in three women worldwide, can result in significant psychiatric morbidity and suicide. Eye movement desensitization and reprocessing (EMDR) offers health care providers the option of a brief psychiatric intervention that can result in psychiatric healing in as few as four sessions. Because health care providers often hear stories of sexual violence from their patients, they are in an ideal position to make recommendations for treatment. The purpose of this article is to introduce health care providers to the technique of EMDR, review safety and appropriateness, and discuss clinical and research implications.