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Carr, Alan
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Carr, Alan
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Carr, Alan
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- PublicationChild sexual abuse: A comprehensive family based approach to treatmentNarrow definitions of CSA which focus on repeated penetrative abuse yield prevalence rates of 2% and 4% for males and females respectively. Most abusers are male. About two thirds of all victims develop psychological symptoms and for a fifth these problems remain into adulthood. Children who have been sexually abused show a range of conduct and emotional problems coupled with oversexualized behaviour. Traumatic sexualization, stigmatization, betrayal and powerlessness are four distinct yet related dynamics that account for the wide variety of symptoms shown by children who have been sexually abused. The degree to which children develop the four traumagenic dynamics and associated behaviour problems following sexual abuse is determined by stresses associated with the abuse itself and the balance of risk and protective factors within the child's family and social network. Case management requires the separation of the child and the abuser to prevent further abuse. A family therapy based multisystemic programme of therapeutic intervention should help the child process the trauma of the abuse and develop protective relationships with non-abusing parents and assertiveness skills to prevent further abuse. For the abuser therapy focuses on letting go of denial and developing and abuse free lifestyle.
251 - PublicationSupporting parents of adolescent perpetrators of CSAThe importance of parental involvement in the treatment of their adolescent CSA perpetrators cannot be underestimated. One of the defining differences between the fields of adult and adolescent sexual offending is the fact that adolescents are still in a formative stage of development. Parents can still exercise a major influence in re-engaging children back on a normative developmental pathway and reducing future risk to a minimum. It is also important to include parents of adolescent CSA perpetrators in treatment programmes because it is well documented in Irish and international studies that some have significant problems.
419 - PublicationProfiles of cases referred for CSA assessmentThe present study aimed to build on the findings of other Irish studies by profiling a cohort of cases in which CSA had occurred or where there was a high probability that it had occurred on a wider range of variables than used in previous studies. Of particular interest was the status of the cohort on variables in the following domains: circumstances of referral, demographic characteristics, family adversity, characteristics of abusive experiences, perpetrator characteristics, strategies to achieve compliance and factors hindering disclosure, emotional and behavioural problems before and after disclosure, and factors supporting credibility of allegations. We also wished to examine the associations between variables in these domains.
145 - PublicationPrevalence of CSA in IrelandProfessionals involved in working with victims or perpetrators of childhood sexual abuse (CSA) require a basic understanding of the nature of this problem in our society. The purpose of this article is to aid such an understanding from an Irish perspective by attempting a synthesis of two excellent and comprehensive research studies. Although these studies first appeared in the literature some time ago their findings remain relevant and in need of dissemination.
431 - PublicationProfiles of adolescent perpetrators of CSAStudies of the psychological adjustment of adolescents who sexually abuse other youngsters have shown that they differ from normal control groups, and hold some features in common with clinical control groups with other psychological problems and incarcerated control groups convicted of non-sexual offences. For example, they show more behaviour problems than normal controls but not incarcerated controls; they have difficulties with making and maintaining friendships and establishing empathy with others; they have problems with impulse control, anger management and assertiveness; and they come from families characterized by a variety of problems. Despite the burgeoning international literature in this area, few studies have been conducted on Irish adolescent sexual abusers and non-adjudicated abusers.
181 - PublicationProfiles of parents of adolescent perpetrators of CSAThe present study aimed to expand our knowledge about the profiles of families of adolescent CSA perpetrators by comparing a group of parents of adolescent sexual offenders (PASO); a clinical control group (CC) of parents of non-offending adolescents attending a child and adolescent mental health service; and a normal control group (NC) of parents of non-offending adolescents in the community on a range of demographic, developmental, personal adjustment and family environment variables.
241 - 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.
387Scopus© Citations 14 - 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.
786Scopus© Citations 34 - PublicationProfiles of child sexual abuse cases in Ireland: an archival study(Elsevier, 2002-04)
; ; ; ; ; Objective: This study aimed to profile subgroups of CSA cases referred for assessment at two national CSA assessment centers in Ireland. Method: Historical and clinical data for 150 CSA cases were drawn from records of two Dublin-based national specialist sexual abuse assessment and therapeutic centers. Three main comparisons were made involving: (1) 113 confirmed CSA cases and 37 unconfirmed CSA cases, (2) 55 confirmed CSA cases that displayed clinically significant behavior problems, and the 56 confirmed CSA cases without significant adjustment difficulties, and (3) 19 confirmed CSA cases in which violence was a central feature, and 79 confirmed cases in which violence was not a central feature. Results: There were three main findings. (1) More unconfirmed cases were male; had single or separated parents; and a father with a criminal history. As a group, the confirmed cases were largely youngsters who had been abused by male adults or adolescents outside their nuclear family and who subsequently were well supported by one or two parents. (2) Poorly adjusted CSA victims had a history of coercive violent abuse while better adjusted children were victims of nonviolent abuse. (3) Victims of violent CSA were more likely to have experienced penetrative abuse and to display more externalizing behavior problems. Conclusions: Confirmed and unconfirmed CSA cases, well and poorly adjusted CSA cases, and victims of violent and nonviolent CSA referred for assessment at two national CSA assessment centers in Ireland had distinctive clinical profiles.1006Scopus© Citations 3