A salutogenic approach to healing following child sexual assault

Decades of research has now produced a rich description of the destruction child sexual assault (CSA) can cause in an individual’s life. Post-Traumatic Stress Disorder (PTSD), Dissociative Identity Disorder, Borderline Personality Disorder, depression, anxiety, Panic Disorder, intimacy issues, substance abuse, self-harm, and suicidal ideation and attempts, are some of the negative outcomes that have been attributed to this type of traumatic experience. Psychology's tendency to dwell within a pathological paradigm, along with popular media who espouse a similar rhetoric, would lead to the belief that once exposed to CSA, an individual is forever at the mercy of dealing with a massive array of accompanying negative effects. While the possibility of these outcomes in those who have experienced CSA is not at all denied, it is also timely to consider an alternative paradigm that up until now has received a paucity of attention in the sexual assault literature. That is to say, not only do people have the ability to work through the painful and personal impacts of CSA, but for some people the process of recovery may provide a catalyst for positive life changes that have been termed post-traumatic growth (Tedeschi & Calhoun, 1995). To begin with in this chapter, the negative sequale’ of childhood sexual assault it discussed initially. Inherent to this discussion are questions of measurement and definitions of sexual assault. The chapter highlights ways in which the term CSA has been defined and hence operationalised in research, and the myriad problems, confusions, and inconclusive findings that have plagued the sexual assault literature. Following this is a review of the sparse literature that has conceptualised CSA from a more salutogenic (Antonovsky, 1979) theoretical orientation. It is argued that a salutogenic approach to intervention and to research in this area, provides a more useful way of promoting healing and the gaining of wisdom, but importantly does not negate the very real distress that may accompany growth. This chapter will then present a case study to elucidate the theoretical and empirical literature discussed using the words of a survivor. Finally, the chapter concludes with implications for therapeutic practice, which includes some practical ways in which to promote adaptation to life within the context of having survived this insidious crime.

Medical evidence in child sexual assault cases

Purpose – Previous studies suggest that the presence of medical evidence is rare in child sexual assault (CSA) cases, and if present at all, such evidence is unlikely to identify a specific assailant. This study aims to examine the role medical evidence plays in criminal cases of CSA. Specifically, the prevalence of medical evidence in CSA cases, its impact on decisions to prosecute CSA cases, as well as its effect on conviction rates are examined.

Design/methodology/approach – A systematic literature review was conducted on the impact of medical evidence in criminal child sexual abuse (CSA) cases.

Findings – The results of the review suggest medical evidence increases the likelihood of prosecution; however the impact of medical evidence on conviction rate is equivocal.

Research limitations/implications – The implications of these findings for legal and psychological practice, government policy and future areas for academic research are discussed.

Originality/value – To the authors' knowledge, no other review has systematically examined the role of medical evidence on the prosecution and conviction of CSA cases.

Mock jury attitudes towards credibility, age, and guilt in a fictional child sexual assault scenario

Low conviction rates of child sexual assault (CSA) remain a persistent social problem in Australia. One reason for this may be the impact of attitudes regarding the victims when the evidence is weak. This article examines the effects of victim age on perceptions of credibility and verdict in a CSA case. Eleven electronic focus groups deliberated a fictional CSA case, in which the age of the child was systemically varied between 6 and 15 years. Deliberation transcripts were analysed with NVivo (Version 9, QSR International Pty Ltd., Burlington, MA, USA), from which thematic clusters were derived. Results showed that as the child's age increased, credibility and guilty verdicts decreased. In addition, testimony alone had little impact in influencing the verdict. These findings suggest that in lieu of corroborating evidence, increasing supporting information, such as expert testimony, and providing structured deliberation for the jury may reduce the influence of victim blame, particularly when the child victim is older.

Attitudes towards younger and older victims of child sexual assault

The findings of this thesis showed that while mock jury groups perceived older children as less credible, other factors such as lack of evidence and testimony were important considerations in the determination of guilt.

Sentencing in child sexual assault cases: factors influencing judicial decision-making

To date, there has been limited examination of variables that influence sentencing in child sexual abuse cases. This study examines the extent to which offence characteristics (such as the number of offences, number and age of victims), the behaviour and perceived credibility of the victim impact upon both sentence length and the setting of earliest parole dates. Analyses conducted using data from 66 adjudicated cases of child sexual assault from the County Court of Victoria, Australia revealed that longer sentences were handed down to offenders who had perpetrated multiple offences, or who had committed offences against younger children. Lower levels of victim credibility were associated with shorter sentences and earlier parole dates for offenders, which were also associated with the presence of more harmful behavioural indicators of abuse. The findings are discussed regarding the importance of presenting evidence about the behaviour of victims following sexual abuse in criminal trials. © 2013 Copyright National Organisation for the Treatment of Abusers.

Pathways to peace : a phenomenological exploration of the processes of healing and posttraumatic growth following childhood sexual assault

This thesis explored pathways to healing in men and women who experienced traumatic sexual abuse in childhood and considered themselves to be in a place of wellness. The thesis synthesises current knowledge in this area and has produced a number of models with direct implications for clinical practice. This unique work has also contributed to advancing theoretical understanding of healing following sexual assault.

A case study of child sexual abuse within a Church community

A case study is presented of child sexual assault within a church community. How does a church community deal with the accusation of an adolescent female that-as a 13-year old-she was sexually victimised and assaulted by her then 18-year old boyfriend, five years her senior? Practical and pastoral issues, as well as ethical and legal concerns are addressed. Consideration is also given to the theological context of the church environments in which the situations arise. The implications for victims, perpetrators, leaders, and the church community of our actions-and failure to take appropriate action-are described, along with recommendations for prevention, and best practice in dealing with the sexual abuse of minors within church communities.

Prosecutors' perspectives on clarifying terms for genitalia in child sexual abuse interviews

In investigative interviews with alleged victims of child sexual abuse, professionals must establish the nature of the alleged abuse by determining what body parts were involved in the offending. This can be difficult, however, because children often use colloquial (non-anatomical) terms to describe genitalia, and there has been little direction for interviewers about clarifying these terms sufficiently to establish the charge. The aim of this study was to address the need for guidance from prosecutors about the level of clarity in terms required from a legal perspective, and how this clarity can be achieved. A focus group of nine prosecutors (representing all but one Australian State and Territory) were asked to consider what degree of clarity in terminology for genitalia was adequate and how such clarity could be achieved. Thematic analysis revealed that a reduction in specific questioning around genitalia would improve the usefulness of investigative interviews with children from a legal perspective. Recommendations for improving interviews about abuse with child witnesses are discussed. © 2014 The Australian Psychological Society.

Multi-victim sexual assault : a case study in rural Australia

Objective: There is a paucity of information regarding cases of multi-victim sexual assault of children. The reported incidence suggests that these cases are rare. The aim of this paper is to provide practitioners with information about effective intervention strategies arising out of the direct experience of managing a case of multi-victim sexual assault in an Australian rural community. --------- Method: A descriptive, case-report methodology summarizing the investigation and intervention in a case of multi-victim sexual assault is reported. A community based intervention arising out of the disclosures of 21 male children is described. The intervention occurred at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. ---------- Results: The coordination of police and welfare services increased the communication flow to victims, their families, and the community. The case also demonstrated the utility in regularly briefing political and bureaucratic authorities as well as local officials about emergent issues. Coordinating political and bureaucratic responses was essential in obtaining ongoing support and sufficient researching to enable the effective delivery of services. ---------- Conclusions: Interventions were focused at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. This provided a choice of services which were sensitive to the case setting. Recommendations are offered for practitioners who are confronted with similar events. While this paper describes an approach for intervening in a case of multi-victim sexual assault, further empirical research is needed to enable service deliverers to efficaciously target interventions which offer choice to victims and their families.

Child sexual abuse in China : a meta-analysis of 27 studies

Objective: To examine whether Chinese studies of child sexual abuse (CSA) in the general population show lower prevalence rates than other international studies, and whether certain features of these studies may help to account for variation in estimates. Methods: A meta-analysis and meta-regression were conducted on 27 studies found in the English and Chinese language peer reviewed journals that involved general populations of students or residents, estimated CSA prior to age 18, and specified rates for males or females individually. Results: Estimates for Chinese females were lower than the international composites. For total CSA for females, the Chinese pooled estimate was 15.3% (95% CI = 12.6–18.0) based on the meta-analysis of 24 studies, lower than the international estimate (Stoltenborgh, van IJzendoorn, Euser, & Bakermans-Kranenburg, 2011) but not significantly. For contact CSA for females, the pooled estimate was 9.5% (95% CI = 7.5–11.5), based on 16 studies, significantly lower than the international prevalence. For penetrative CSA for females, the pooled estimate was 1% (95% CI = 0.7–1.3), based on 15 studies, significantly lower than the international estimate of 15.1%. Chinese men reported significantly less penetrative CSA but significantly more total CSA than international estimates; while contact CSA reported by Chinese and international males appeared to be roughly equivalent. Chinese CSA prevalence estimates were lower in studies from urban areas and non-mainland areas (Hong Kong and Taiwan), and in surveys with larger and probability samples, multiple sites, face-to-face interview method and when using less widely used instruments. Conclusions: The findings to date justify further research into possible cultural and sociological reasons for lower risk of contact and penetrative sexual abuse of girls and less penetrative abuse of boys in China. Future research should examine sociological explanations, including patterns of supervision, sexual socialization and attitudes related to male sexual prowess. Practice implications: The findings suggest that future general population studies in China should use well validated instruments, avoid face-to-face interview formats and be careful to maintain methodological standards when sampling large populations over multiple sites.

Sex, love and abuse : discourses on domestic violence and sexual assault

Sex, Love and Abuse intervenes in a timely way on some important issues that have become 'elephants in the room' for academic and policy considerations around sexual violence and abuse. In so doing, this book draws upon a range of literatures and novel empirical sources to encourage critical thinking about the relationship between sex, love and abuse, examining crimes including sexual assault, pornography, child sexual abuse and domestic violence. This provocative book seeks to destabilize essentialist understandings of these phenomena with a view to identifying the subtle and complex nature of relationships, which often defy easy explanation and categorisation. Focusing on theories, public discourses and moral ideals, Hayes connects romantic love, intimacy and harm in a unique philosophical analysis, exploring abuse in relationships and how such abuse is fostered.

Professionals' perceptions of a new model of sexual assault investigation adopted by Victoria Police

This article presents a qualitative evaluation of a new method of operation for sexual assault investigation developed by Victoria Police. The model is characterised by two core components: the establishment of specialist teams of investigators responsible for investigation and victim support; and the establishment of service sites, referred to as 'Multidisciplinary Centres', where all key services are located in a single building separate from police stations. The research approach consisted of in-depth interviews with 90 stakeholders (police, counsellors, medical officers, child protection workers and prosecutors). Collectively, these interviews revealed strong, unanimous support for the ideologies that underpinned the new reforms. Reported outcomes included the following: improved collaboration; increased victim satisfaction, referrals between professionals and reporting rates; reduced response and investigation times; better quality briefs; and higher prosecution and conviction rates. These findings, along with the stakeholders' suggestions for further improvements, are discussed.

Prosecutors' recommendations for improving child witness statements about sexual abuse

Child sexual abuse cases are often not prosecuted because of poor evidential quality. The aim of this study was to elicit suggestions from prosecutors as to how investigative interviews with child witnesses (the main form of evidence in child abuse cases) could be improved. Thirty-six in-depth phone interviews were held with 19 trial prosecutors shortly before and after trials. For each case, prosecutors were asked to provide feedback about the strengths and limitations of the child witness interviews, along with suggestions for how the interviews could have been improved. Thematic analysis revealed three broad areas for improvement: the need for tighter focus on the elements of the offence, better clarification of inconsistencies and ambiguities in the account, and greater consideration of how the child presents in the eyes of the jury. These areas, along with the prosecutors' practical suggestions, are outlined. The paper concludes with a discussion of the implications of these findings for trainers in child witness interviewing.

A prosecutor's guide to improving child witness interviews about alleged sexual abuse: a view from the Australian context

Child sexual abuse (CSA) cases are often not prosecuted because of poor evidential quality of the investigative interview, the central plank of CSA investigations and prosecutions. The current paper addresses the need for further direction about how investigative interviews can better meet the needs of prosecutors by presenting a transcript of interview with an experienced Crown prosecutor. In the interview, we asked the prosecutor to explain what information is required, and how information should be elicited from a prosecution perspective. The transcript was then distributed to nine Crown prosecutors who were invited to reflect on the propositions made in the transcript and indicate any areas where the prosecutor’s views were not consistent with their own. The nine prosecutors then met as a group and agreed on amendments to the transcript to ensure it was representative of their views. We present the final transcript (with amendments) as a tool for interviewers and trainers.

Police and prosecutors' perceptions of adult sexual assault evidence associated with case authorisation and conviction

This study examined the association between the quality of verbal evidence in cases of sexual assault reported by adults and professionals’ (police and prosecutor) ratings of the likelihood that the cases will result in a conviction at trial. Sixteen police detectives and 19 prosecutors (all specialists in sexual assault) each read two mock sexual offence briefs of evidence, one of a case involving rape of an adult and the other involving an adult reporting historical child sexual abuse. For each case type, two versions of the briefs were developed with regard to evidence quality, which varied according to the degree of elaboration in the responses by the witnesses and suspect, and contextual evidence. Participants rated the likelihood of proceeding with a case and conviction (on 10-point likert scales) and provided a rationale for their decisions. Almost all of the participants agreed that the cases would proceed to court. However, the likelihood of conviction was not associated with the likelihood of proceeding to court, or the evidence quality of the briefs. Differences were found in both the ratings of proceeding to court and conviction, and the factors underpinning the ratings across the two professional groups. The implications of the findings for police organisations are discussed.