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Carr, Alan
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Carr, Alan
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Carr, Alan
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- PublicationProfiles of the parents of adolescent CSA perpetrators attending a voluntary outpatient treatment programme in IrelandA group of 22 parents of adolescent sexual offenders (PASO) was compared with a group of 19 normal controls (NC) and 10 clinical controls (CC) on demographic, developmental, personal adjustment and family environment variables. The assessment protocol included the General Health Questionnaire –12, the Culture-Free Self-Esteem Inventory, the Child Behaviour Checklist, the Family Assessment Device, the Parent Satisfaction Scale, and the Multidimensional Scale of Perceived Social Support. Compared with clinical and normal controls, more parents in the PASO group reported that they had been arrested orcharged for a criminal offence; had personally experienced child abuse; and more of their adolescents had experienced child abuse, with emotional abuse being the most common form of abuse for both parents and adolescents. Compared with clinical and normal controls, more adolescents of parents in the PASO group had witnessed parental drug or alcohol abuse and had been placed in care outside their home. While parents in the PASO group did not differ from clinical or normal controls in terms of personal adjustment, their adolescents had significantly more internalizing behaviour problems than normal controls, whereas adolescents of parents in the clinical control group had significantly more externalizing behaviour problems than normal controls. Compared with normal controls, parents in both the PASO and clinical control groups reported more difficulties with general family functioning, roles, affective responsiveness, affective involvement and behaviour control and lower levels of parental satisfaction. But the groups did not differ significantly in their levels of perceived social support.
492Scopus© Citations 16 - PublicationExperiences of parents attending a programme for Families of adolescent CSA perpetrators in IrelandThe NIAP Parents’ Group Programme is a psycho-educational support group for parents of adolescents who have committed a sexual offence. In this qualitative study of 5 programme participants, their self-reported psychological adjustment, self-esteem and perceived social support improved over the course of treatment. From a thematic content analysis of responses to semistructured interviews conducted before and after the programme and midway through it a conceptual model of the processes parents’ experience in reaction to the disclosure of their sons’ sexual offence was developed. The model proposes relationships between parental shock, confusion, searching and questioning, disbelief or minimisation, acceptance, shame, selfblame, guilt, anger and sadness. The model my inform future research and clinical practice with parents of adolescent CSA perpetrators.
277Scopus© Citations 13 - PublicationFamily–oriented treatment for people with alcohol problems in Ireland: a comparison of the effectiveness of residential and community–based programmesUsing a naturalistic design involving consecutive referrals self-selected for family-oriented treatment, 42 participants from a residential programme and 25 participants from a community-based programme were assessed on a range of alcohol-use and psychosocial measures before treatment. A proportion of these cases were assessed after treatment and at 6 months follow-up. At six months follow-up 79% of both the residential and community groups were either abstinent or drinking moderately. However, more members of the residential group (75%) were abstinent at follow-up compared with the community group (36%). In contrast, more members of the community group were moderate drinkers (43%) at follow-up compared with the residential group (4%). At six months follow-up, compared with the community group, more members of the residential group showed a clinically significant reduction in recent negative consequences of drinking and psychological adjustment problems. Both groups made significant mean gains on indices of alcohol abuse and psychosocial adjustment but there were important intergroup differences. The residential group showed a greater mean reduction in recent negative consequences from drinking but the community group showed a greater mean reduction in the percentage of days heavy drinking.
449Scopus© Citations 8 - PublicationPsychological profiles of sexually abusive adolescents in IrelandObjective. This study aimed to profile the psychological and psychosocial characteristics of a group of Irish adolescents who had sexually abused other youngsters. Method. Levels of behaviour problems, personal adjustment, anger management and psychosocial adjustment were compared in 27 Irish adolescents with a history of sexual abusing another youngster (SA group); 20 clinical controls who had significant behavioural problems but no history of sexual offending (CC group); and 29 normal controls who were without significant psychological problems (NC group). Measures used included the Child Behaviour Checklist (CBCL); the Youth Self Report Form (YSR); selected scales from Beckett (1997) Adolescent Sex Offender Assessment Pack (ASOAP); and the Family Environment Scale (FES). Results. Compared with the CC group the SA group displayed fewer problems overall on the CBCL and the YSR. The SA group showed problems with self-esteem, emotional loneliness, and perspective taking similar to those of the CC group, but their impulsivity scores were similar to those of the NC group. The locus of control scores of the SA group fell between those of the CC and NC groups. The SA group showed an anger management profile which fell at an intermediate position between those of the NC and CC groups. The SA group showed problematic family functioning in the areas of expressiveness, behaviour control and social support similar to those of the CC group. Their difficulties with family cohesion were less severe than those of the CC group but worse than those of the NC group. Conclusions. Overall the psychological adjustment of adolescents with a history of sexual abusing others was more problematic that of normal controls but less problematic than that of youngsters who had significant behavioural problems but no history of sexual offending.
804Scopus© Citations 16 - PublicationPerceptions of the criminal justice system and its association with well-being following a report of child sexual abuse(National Organisation for the Treatment of Abusers (NOTA Ireland), 2007)
; ; ; 42 - PublicationChild sex abuse and the Irish criminal justice systemThe aims of this study were to develop scales to assess experiences of sexually abused children in the Irish criminal justice system (CJS); identify aspects of the CJS which children experience as negative; compare the perceptions of children, parents and professionals of sexually abused children's experiences of the CJS; and determine correlations between perceptions of children's CJS experiences and current psychological adjustment. Forty-three children, 101 parents, 32 mental health professionals, 27 police officers and 21 lawyers completed parallel versions of the Criminal Justice System Questionnaire (CJSQ) which assessed satisfaction with aspects of the CJS relevant to sexually abused children, specifically: Gardaà (police), medical examination, Director of Public Prosecutions, waiting for court, court professionals, court context and the CJS. Fifteen scales were developed by conducting principal component analyses. Children gave negative ratings on nine of these, and on seven children, parents and professionals differed in their perceptions of how children experienced the CJS with mental health professionals viewing the impact of the CJS as more problematic than parents and children. Scores of children and parents on CJSQ scales correlated with indices of current psychological adjustment. These results point to the importance of making the Irish CJS more child-friendly and for evaluating these reforms with the CJSQ. Copyright © 2011 John Wiley & Sons, Ltd.
378Scopus© Citations 8 - PublicationDevelopment of a Children's Version of the SCORE Index of Family Function and ChangeThe Systemic Clinical Outcome and Routine Evaluation (SCORE) Index of Family Function and Change is a recently developed outcome measure. It was designed to be acceptable to adults and children aged 12 and over. Thus far no research has been conducted using the SCORE in children under the age of 12. The aim of this study was to pilot a children's version of the SCORE. An existing 29-item version of the SCORE was completed by a sample of seven children aged 8–10. Time was allowed for group discussion with the children. Feedback from this stage of the study was used to develop a draft version of the SCORE for children. An expert panel of clinicians and researchers were also consulted. A pilot version of the Child SCORE was administered to 80 children aged 7–10 in an inner London primary school. Thirty-five children also completed the measure for a second time, 1 week later. Findings suggested that the Child SCORE was acceptable to children in the 8–11 age range. Values for internal reliability and test–retest reliability were good. The Child SCORE appears to be a promising instrument. Further research is required to confirm its acceptability to clinical populations, and to demonstrate sensitivity to change.
434Scopus© Citations 27 - PublicationA Controlled Evaluation of Mindfulness-Based Cognitive Therapy for Patients with Coronary Heart Disease and DepressionThis study evaluated the effectiveness of an eight-session mindfulness-based cognitive therapy (MBCT) group intervention programme for treating depression in coronary heart disease (CHD) patients. Thirty-two depressed CHD patients were assigned to an MBCT treatment group, and a demographically and clinically similar group of 30 cases were assigned to a waiting list control group. Participants were evaluated at baseline, 8 weeks, and 6-month follow-up with the Hospital Anxiety and Depression Scale (HADS), Brief Symptom Inventory (BSI), Profile of Mood States (POMS), Psychosocial Adjustment to Illness Scale (PAIS) and the Mindful Attention Awareness Scale (MAAS). After each session, MBCT participants completed the post-session Questionnaire on helpful aspects of therapy and after the programme, completed the Client Satisfaction Questionnaire. At follow-up, 71 % of the MBCT group was clinically recovered from depression compared with 50 % of the control group. The MBCT group showed significantly greater improvement than the control group on all measures with effect sizes at follow-up of d = 0.43–1.0. Increases in mindfulness on the MAAS correlated significantly with improvements on the HADS, BSI, POMS and PAIS. Key helpful aspects of therapy identified by MBCT participants included learning meditation, obtaining group support and developing optimism. There was a high level of satisfaction with the MBCT programme. These results indicate that a randomized controlled trial of MBCT for depressed CHD patients is now warranted.
857Scopus© Citations 22 - PublicationProfiles of Irish survivors of institutional abuse with different adult attachment styles(Routledge (Taylor & Francis), 2009)
; ; ; ; ; ; ; ; Two hundred and forty seven survivors of institutional abuse in Ireland were classified with the Experiences in Close Relationships Inventory as having fearful (44%), preoccupied (13%), dismissive (27%) or secure (17%) adult attachment styles. The group with the secure adult attachment style had the most positive profile, while the most negative profile occurred for the fearful group in terms of DSM IV diagnoses and scores on the Trauma Symptom Inventory, the Global Assessment of Functioning Scale, the World Health Organization Quality of Life 100 scale, and the Kansas Marital Satisfaction Scale. The profile of the preoccupied group was more similar to that of the fearful group. The profile of the dismissive group was more similar to that of the secure group577Scopus© Citations 10 - PublicationA comparison of two programmes for victims of child sexual abuse: a treatment outcome studyThis study aimed to evaluate the comparative effectiveness of individual therapy and combined individual and group therapy in the treatment of the psychological sequelae of child sexual abuse. The Child Behaviour Checklist (CBCL), the Youth Self Report form (YSR), the Children's Depression Inventory (CDI) and the Trauma Symptom Checklist for Children (TSCC) were administered before treatment and 6 months later to a group of 20 young people who participated in individual therapy (IT) programmes and to a group of 18 young people who participated in programmes that involved combined individual and group therapy (IGT). For both types of programmes, statistically significant improvement occurred on the following scales: the total problems, internalizing problems, externalizing problems, withdrawn, somatic complaints, anxious/depressed, social problems, attention problems and aggressive behaviour problems CBCL scales; the total depression, interpersonal problems and anhedonia CDI scales; and the depression and anger TSCC scales. The only scale for which one therapy programme led to greater improvement than another was the CDI ineffectiveness scale. The IGT programme led to a reduction in the mean CDI ineffectiveness score, whereas a slight increase in the mean ineffectiveness score occurred in the IT group. There were no significant differences in the rates of clinically significant improvement associated with the two treatments and no major differences between cases who improved and those that did not improve over the course of therapy. From this study, it may be concluded that after 6 months, individual therapy and combined individual and group therapy were equally effective in the treatment of the psychological sequelae of child sexual abuse.
699Scopus© Citations 32