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Dion J, Attard V, Guyon R, De La Sablonnière-Griffin M, Perreault É, Hébert M. Implementing a sexual violence prevention program in two Canadian Indigenous communities: Challenges and lessons learned. CHILD ABUSE & NEGLECT 2024; 148:106271. [PMID: 37357071 DOI: 10.1016/j.chiabu.2023.106271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/22/2023] [Accepted: 05/31/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND The prevalence of child sexual violence remains overwhelming, particularly among Indigenous populations, despite increased awareness. Therefore, implementing efficient initiatives is crucial in preventing and reducing sexual violence rates among these groups. OBJECTIVE This study aimed to examine the processes involved in the implementation of a sexual violence prevention program in two Indigenous communities in Canada and assess application of culturally safe practices. METHOD Eight Indigenous and non-Indigenous project managers underwent semi-structured interviews before the program's implementation; five of them also participated in the follow-up interviews. Moreover, thirteen Indigenous service providers from the two communities answered open-ended questions when the included training ended. RESULTS Thematic analysis revealed the importance of following an ongoing process (not only before implementing a program) to assess the needs of community members and involving them in decision-making. Administrative injunctions were also identified as a significant challenge during implementation. Results showed that participants reported the taboo of sexual violence as a challenge but that constant discussions about the prevention of sexual violence helped defuse the discomfort and foster trust between Indigenous and non-Indigenous professionals. Finally, participants provided recommendations to improve research and intervention practices. CONCLUSIONS Several takeaways were discussed to improve research practices with, by, and for Indigenous peoples, such as using collaborative communication, developing common understanding relative to work agendas, and increasing cultural competencies to build trust within the partnership.
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Affiliation(s)
- Jacinthe Dion
- Intersectoral Center for Sustainable Health, Department of Health Sciences, Université du Québec à Chicoutimi, 555 bl. Université, Saguenay, Québec G7H 2B1, Canada; Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada.
| | - Virginie Attard
- Urbanisation Culture Société Research Centre, Institut National de la Recherche Scientifique (INRS), INRS-UQAT Joint Research Unit in Indigenous Studies, Val-d'Or Campus, 663, 1re Avenue, Val-d'Or, Québec J9P 1Y3, Canada.
| | - Roxanne Guyon
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada; Department of Sexology, Université du Québec à Montréal, 455, boul. René-Lévesque Est, Montréal, Québec H2L 4Y2, Canada.
| | - Mireille De La Sablonnière-Griffin
- Urbanisation Culture Société Research Centre, Institut National de la Recherche Scientifique (INRS), INRS-UQAT Joint Research Unit in Indigenous Studies, Val-d'Or Campus, 663, 1re Avenue, Val-d'Or, Québec J9P 1Y3, Canada.
| | - Émilie Perreault
- Intersectoral Center for Sustainable Health, Department of Health Sciences, Université du Québec à Chicoutimi, 555 bl. Université, Saguenay, Québec G7H 2B1, Canada.
| | - Martine Hébert
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada; Department of Sexology, Université du Québec à Montréal, 455, boul. René-Lévesque Est, Montréal, Québec H2L 4Y2, Canada.
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Prévenir la violence sexuelle durant la petite enfance : une évaluation des effets de la formation Lanterne auprès du personnel de milieux d’intervention et d’éducation. SEXOLOGIES 2022. [DOI: 10.1016/j.sexol.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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McGuire A, Steele RG, Singh MN. Systematic Review on the Application of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Preschool-Aged Children. Clin Child Fam Psychol Rev 2021; 24:20-37. [PMID: 33428071 DOI: 10.1007/s10567-020-00334-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/24/2022]
Abstract
Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the most widely studied and disseminated treatments for posttraumatic stress disorder (PTSD) and other comorbid conditions, and has been identified as a "level one" or "well-established" intervention for school-aged children and adolescents. The present systematic review examined the literature on the application of TF-CBT within a preschool-aged population (i.e., children ages three to six), as well as the developmental literature that could increase the efficacy of TF-CBT for preschool-aged children. Information on the use of TF-CBT with preschool-aged children was extracted from randomized controlled trials, case studies, meta-analyses, and other forms of empirical evidence, as part of the evidence-based practice in psychology framework. In comparison to research with school-aged children and adolescents, fewer studies have directly assessed the efficacy of TF-CBT for preschool-aged children who have been exposed to trauma. Given the few studies published to date and difference in treatment protocols for TF-CBT used with preschool-age children, TF-CBT appears to meet criteria as a "level two" or "probably efficacious" intervention for preschool-aged children specifically. According to the available literature, language and cognitive abilities, family context, culture, and clinician expertise are considered as potential variables to address when contemplating the use of TF-CBT for preschool-aged children with symptoms of post-traumatic stress.
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Affiliation(s)
- Austen McGuire
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045-7556, USA.
| | - Ric G Steele
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045-7556, USA
| | - Mehar N Singh
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045-7556, USA
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Intervención psicológica del abuso sexual en niños: Revisión sistemática. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2020. [DOI: 10.33881/2027-1786.rip.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
La literatura ha mostrado terapias para el tratamiento de los síntomas relacionados con situaciones de abuso sexual infantil en adolescentes, jóvenes y adultos. La presente revisión se enfocó en intervenciones para niños víctimas de abuso sexual con edades entre los tres y los doce años. Nos enfocamos en publicaciones en inglés, español, francés y portugués registradas en las bases de datos Science direct, Jstor, Proquest, Redalyc y Scielo. Los resultados mostraron mayor frecuencia de estudio de este tema en poblaciones norteamericanas y europeas, enfocadas en el tratamiento de síntomas o consecuencias en la salud mental tales como baja autoestima, depresión y ansiedad, actitud vital negativa, trastornos alimentarios, estrés postraumático y otras variables relacionadas como bajo rendimiento académico, conductas auto lesivas o suicidas. La terapia cognitivo comportamental individual y grupal y también su modalidad centrada en el trauma, cuenta con una frecuencia mayor de estudios que demuestran su efectividad para el tratamiento. Igualmente se identifican la terapia psicodinámica de juego, la terapia asistida por animales y la terapia de interacción padre-hijo. Se discute el papel que podría jugar las terapias de tercera generación como complementarias para el manejo de los síntomas o consecuencias del abuso sexual en niños.
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Lewey JH, Smith CL, Burcham B, Saunders NL, Elfallal D, O’Toole SK. Comparing the Effectiveness of EMDR and TF-CBT for Children and Adolescents: a Meta-Analysis. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:457-472. [PMID: 32318168 PMCID: PMC7163897 DOI: 10.1007/s40653-018-0212-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Efficacy of EMDR and TF-CBT for posttraumatic stress symptoms (PTSS) was explored through meta-analysis. A comprehensive search yielded 494 studies of children and adolescents with PTSS who received treatment with these evidence-based therapeutic modalities. Thirty total studies were included in the meta-analysis. The overall Cohen's d was small (-0.359) and statistically significant (p < 0.05), indicating EMDR and TF-CBT are effective in treating PTSS. Major findings posit TF-CBT is marginally more effective than EMDR; those with sub-clinical PTSS responded more favorably in treatment than those with PTSD; and greater reductions in PTSS were observed with presence of comorbidity in diagnosis. Assessment of publication bias with Classic fail-safe N revealed it would take 457 nonsignificant studies to nullify these findings.
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Affiliation(s)
- Jennifer H. Lewey
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, 5130 E. Clinton Way, Fresno, CA 93727 USA
- Direct Care and Treatment - Forensic Services (DCT-FS), Minnesota Department of Human Services (DHS), St. Peter, MN USA
| | - Christopher L. Smith
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, San Francisco, CA USA
- Youth Opportunities Upheld, Inc. (YOU, Inc.), Worchester, MA USA
| | - Brandi Burcham
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, 5130 E. Clinton Way, Fresno, CA 93727 USA
| | - Nia L. Saunders
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, 5130 E. Clinton Way, Fresno, CA 93727 USA
| | - Dina Elfallal
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, 5130 E. Clinton Way, Fresno, CA 93727 USA
| | - Siobhan K. O’Toole
- Clinical Psychology Department, California School of Professional Psychology at Alliant International University, 5130 E. Clinton Way, Fresno, CA 93727 USA
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Abstract
The aim of this longitudinal study was to examine the course of sexualized behavior problems (SBP) over 2 years in a sample comprised of 104 children aged 2-12, including 62 children with histories of child sexual abuse (CSA). Parents completed questionnaires assessing SBP, internalizing and externalizing difficulties at baseline, as well as 2 years later. In more than half (56.7%) of children with clinically significant SBP at baseline, sexualized behaviors persisted and remained at a clinically significant level over time. In children with CSA, 48.4% presented persistent SBP, 27.4% presented transitory SBP, while 19.4% did not present clinically significant SBP at either time. CSA increased the relative risk of persistent SBP 3.29 times, and for each one-unit increase in scores of externalizing difficulties, the odds of persistent SBP increased by 21%. The findings suggest that SBP consequent to CSA, especially when it co-occurs with externalizing difficulties, is likely to remain at levels warranting clinical intervention.
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Efficacy of Trauma-Focused Cognitive Behavioral Therapy in Facilitating Posttraumatic Growth and Emotional Management Among Physically Abused Children. Trauma Mon 2017. [DOI: 10.5812/traumamon.62149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Konanur S, Muller RT, Cinamon JS, Thornback K, Zorzella KPM. Effectiveness of Trauma-Focused Cognitive Behavioral Therapy in a community-based program. CHILD ABUSE & NEGLECT 2015; 50:159-170. [PMID: 26318778 DOI: 10.1016/j.chiabu.2015.07.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/10/2015] [Accepted: 07/19/2015] [Indexed: 06/04/2023]
Abstract
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a widely used treatment model for trauma-exposed children and adolescents (Cohen, Mannarino, & Deblinger, 2006). The Healthy Coping Program (HCP) was a multi-site community based intervention carried out in a diverse Canadian city. A randomized, waitlist-control design was used to evaluate the effectiveness of TF-CBT with trauma-exposed school-aged children (Muller & DiPaolo, 2008). A total of 113 children referred for clinical services and their caregivers completed the Trauma Symptom Checklist for Children (Briere, 1996) and the Trauma Symptom Checklist for Young Children (Briere, 2005). Data were collected pre-waitlist, pre-assessment, pre-therapy, post-therapy, and six months after the completion of TF-CBT. The passage of time alone in the absence of clinical services was ineffective in reducing children's posttraumatic symptoms. In contrast, children and caregivers reported significant reductions in children's posttraumatic stress (PTS) following assessment and treatment. The reduction in PTS was maintained at six month follow-up. Findings of the current study support the use of the TF-CBT model in community-based settings in a diverse metropolis. Clinical implications are discussed.
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Affiliation(s)
- Sheila Konanur
- Department of Psychology, Faculty of Health, York University, Canada
| | - Robert T Muller
- Department of Psychology, Faculty of Health, York University, Canada
| | - Julie S Cinamon
- Department of Psychology, Faculty of Health, York University, Canada
| | - Kristin Thornback
- Department of Psychology, Faculty of Health, York University, Canada
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