Ian Barron

School-Based Child Sexual Abuse Prevention Programs: A Review of Effectiveness

In this systematic and critical review of purely school based child sexual abuse prevention program efficacy studies, 22 studies meeting the inclusion criteria differed by target population, program implementation, and evaluation methodology. Measured outcomes for children included knowledge, skills, emotion, risk perception, touch discrimination, reported response to actual threat or abuse, disclosure, maintenance of gains, and negative effects. Many studies had methodological limitations (e.g., sampling problems, lack of adequate control groups, lack of reliable and valid measures). However, most investigators claimed that their results showed significant impact in primary prevention (increasing all children’s knowledge or awareness and/or abuse prevention skills). There was little evidence of change in disclosure. There was limited follow-up evidence of actual use and effectiveness of prevention skills, and the evidence for maintenance of gains was mixed. Several programs reported some negative effects. Very few studies reported implementation fidelity data, and no study reported cost-effectiveness. Implications for future research, policy, and practice are outlined.

Randomized Control Trial of a CBT Trauma Recovery Program in Palestinian Schools

The current study aimed to assess the Teaching Recovery Techniques (TRT) trauma recovery program within the context of ongoing violence. Utilizing a randomized controlled trial, 11–14-year-old students in Nablus, Palestine, were allocated by class to intervention or wait-list control conditions. Standardized measures assessed trauma exposure, posttraumatic stress disorder (PTSD), grief, and depression. Program fidelity and participant experiences were measured by adherence questionnaires and focus groups. Analyses involved paired t-tests, ANCOVAs, and thematic analysis. Intervention students reported significant decreases in PTSD, grief, and depression. Findings indicate that the TRT program has the potential to ameliorate childrens trauma symptoms during situations of ongoing violence.

Exploratory evaluation of a school-based child sexual abuse prevention program.

Internationally, efficacy studies of school-based child sexual abuse prevention programs display a series of methodological shortcomings. Few studies include adolescent participants, recording of disclosures has been inconsistent, and no studies to date have assessed presenter adherence to program protocols or summated the costs of program implementation. A pretest–posttest waitlist control design was used to evaluate the Tweenees program delivered to grade 6 (n = 88) and grade 7/8 students (n = 117) compared to a control (n = 185). Outcome measures included a knowledge/skills questionnaire, systematic coding of disclosures, and video interaction analysis of lessons. Costs were calculated per student, class, and school. Adolescents made small knowledge and skills gains indicating a program ceiling effect. Implementation analysis suggests low levels of adult control facilitated disclosures. Program costs were relatively inexpensive. Recommendations are made for future research.

School-based child sexual abuse prevention programs: moving toward resiliency-informed evaluation

Although recent years have seen an increase in the range of child sexual abuse prevention programs delivered in schools, there have been relatively few efficacy studies. Those conducted have focused primarily on intrinsic child factors and have often lacked an explicit theoretical framework. We offer resiliency theory as a useful and apposite theoretical framework for program evaluation. Resiliency theory suggests that a wider range of factors should be considered, including intrinsic (personal characteristics) and extrinsic (environmental) factors. Such factors may increase risk or, alternatively, protect children from the negative effects of adversity. We argue that a resiliency perspective to efficacy studies should recognize a long-term view on children’s capacity to cope and can employ both standardized and contextual resiliency-informed measures.

School-based Abuse Prevention: Effect on Disclosures.

This paper focuses specifically on the analysis of disclosures and forms part of a wider study which evaluated the effectiveness of the Violence is Preventable program. Participants included a survivor group, grade 6 group, and a grade 7/8 group with equivalent waiting-list comparison groups. Lessons were delivered either by voluntary organization workers or class teachers. Disclosures were systematically recorded by presenters. Video was used to analyze interactions around disclosures. Substantial numbers of disclosures occurred when lessons were delivered by survivor organisation presenters. Video analysis suggested this was partly due to adult-student interactions characterized by low levels of adult control. Studies on a larger scale are needed particularly comparing outcomes from different presenters with an analysis of what leads to disclosure in and beyond the classroom.

Randomized Control Trial of Teaching Recovery Techniques in Rural Occupied Palestine: Effect on Adolescent Dissociation

ABSTRACT This study assessed the effect of a cognitive behavioral group intervention, Teaching Recovery Techniques (TRT), for adolescents with high levels of posttraumatic stress (n = 154), from villages in occupied Palestine. A randomized control trial involved standardized measures to assess war stressors, posttraumatic stress, depression, and dissociation. Program fidelity was measured by presenter and observer ratings and program delivery cost was calculated per adolescent. High levels of traumatic exposure, dissociation, and posttraumatic stress were found. In comparison to a wait list group (n = 75), TRT adolescents reported significantly fewer posttraumatic stress symptoms postintervention. Depression and dissociation remained stable for TRT adolescents, but worsened for those on the wait list. Given the high returns and low costs, this cost–benefit analysis makes a clear case for TRT to be delivered throughout the West Bank. Longitudinal evaluation is needed to assess adolescent traumatization and the impact of TRT within a context of ongoing violence.

Emotional and Cognitive Responses of Children Attending Summer Campsin Occupied Palestine: A Pilot Study

Background: The current study sought to address the lack of evaluation for summer camps which seek to offer emotional and cognitive support for children in occupied Palestine. Objective: To assess children’s emotional and cognitive response to summer camps, children who attended camps were compared to those who did not attend on a standardised measure of emotion and cognition within situations of adversity. Methods: A mixed methods quasi-experimental post-test only design was used.Children, aged 8-10 years, who attended a summer camp (n=62), were compared to those who had not attended a camp (n=22) on the Child Post-traumatic Cognitions Inventoryand on a qualitative summer experience questionnaire. Camp workers (n= 16) also completed a summer experiences questionnaire for comparison of perceptions betweenworkers and children. Statistical analysis involved t-test and ANOVA for within and between group differences and a six-step quasi-qualitative analysis was used to assess summer experience questionnaire responses. Results: Unexpectedly,children who had attended a summer camp presented higher levels of traumatic cognition; however, they also reported more hopefulness for the future than children who did not attend a camp. It is uncertain if camp attendees are a self-selecting group because of higher levels of traumatic exposure and/or cognitions or because summer camps may have unintended negative consequences. Conclusion: The current study, with its unexpected results, emphasises the importance of embedding evaluation into summer camp delivery. More robust experimental designs, however, are necessary in order to be confident that the outcomes are related to program rather than contextual factors. A range of potential summer camp and environmental influencing factors on outcomes were identified for future research.

Complicated Grief in Palestinian Children and Adolescents

This study aims to identify the traumatic losses and resultant complicated grief of adolescents in occupied Palestine. A secondary analysis was conducted on a data set from 133, 11-14 year olds who had completed the Exposure to War Stressors Questionnaire, the Children’s Revised Impact of Events Scale and the Traumatic Grief Inventory for Children (TGIC). For the first time, a statistically significant cut-off was applied to the TGIC. As a consequence, the co-morbidity of complicated grief was explored with posttraumatic stress disorder and depression. Findings indicate adolescents in Nablus experienced multiple traumatic losses resulting in 20% experiencing complicated grief. Because of the strict statistical cut-off, indications are this may be an underestimate. Complicated grief presented as a distinct trauma response. Recommendations are made for future research and practice.

Adolescents in Secure Accommodation in Scotland: Exposure and Impact of Traumatic Events

ABSTRACT The current study sought, for the first time, to assess the nature of trauma exposure and resultant symptoms in adolescents (n = 17) in secure accommodation in Scotland. A case study mixed methods design involved analysis of case files, trauma history interviews, and standardized trauma symptom questionnaires with adolescents and program staff in 1 facility. A developmental trauma framework was applied to file analysis. Despite extensive abuse and resultant symptoms identified in files, few explicitly reported traumatization. Adolescents in interview, however, reported numerous domestic and institutional traumatic events. High levels of posttraumatic stress (65%), depression (65%), and dissociation (18%) were identified. It appears adolescent traumatization is pervasive in 1 secure accommodation facility in Scotland. Studies across Scotland’s secure facilities are needed to assess reliability of findings. Indications are that staff in secure accommodation need to have an understanding of trauma exposure, resultant symptoms, and how to respond to traumatized adolescents.

Survivor Experience of a Child Sexual Abuse Prevention Program: A Pilot Study

Addressing gaps in the research, the current study assesses the impact of a community-based child sexual abuse prevention program on known survivor knowledge/skills, disclosures, and subjective experience. Methodologically, novel measures of program fidelity and implementation cost are applied. A pre- posttest wait-list control design was utilized with intervention (n = 10) and comparison groups (n = 10). Measures included a standardized knowledge/skill questionnaire, coding of disclosures, subjective experience questionnaires, in-depth interviews, video analysis of program adherence, and a measure of cost. Analysis involved nonparametric tests and thematic analysis of interview and video data. Cost was calculated for the group and per survivor. Survivors achieved significant gains in knowledge/skills, made further disclosures, and were positive about their program experience. No gains were identified in the control group. Costs were small. Future studies need to explore survivor experience of programs delivered in classrooms.