Leslie M. Tutty

The Everyday Occurrence Violence in the Lives of Girls Exploited Through Prostitution

This article reports the results of qualitative interviews with 47 women involved in prostitution from three western Canadian provinces. More than two thirds of the women had become involved at age 15 or younger. The respondents described high rates of violence perpetrated against them. They reported considerable childhood sexual abuse, most often by a family member or by caretakers while they were living in foster care or group homes. The young women continued to experience violence as prostitutes so commonplace that it almost seemed “normal.” They were victimized by pimps, johns, other prostituted women, intimate partners, and representatives from mainstream society and members of the police. This article describes their experiences of violence, the associated health problems, the protective strategies they used, and their attempts to leave the streets. The conclusion suggests ways in which agencies and policies could better address the violence experienced by these young women.

Child sexual abuse prevention programs: evaluating Who Do You Tell

OBJECTIVE The research evaluated a sexual abuse prevention program for elementary school-aged children. Although other evaluations of similar programs have demonstrated significant improvements in knowledge and skills, a number of key questions with respect to their efficacy remain. METHOD 231 children were randomly assigned (matched by age) to participate in the program (N = 117) or in a wait-list control condition (N = 114). Knowledge of abuse prevention concepts were tested using the 33-item Childrens Knowledge of Abuse Questionnaire-Revised (CKAQ-R), a standardized measure with strong psychometric properties (Tutty, 1995), with a new subscale on Appropriate Touch. RESULTS An analysis of covariance showed that children who received the program increased their knowledge levels of both Inappropriate Touch (p = .000) and Appropriate Touch (p = .012) to a significantly greater degree than children in the control group. Age also significantly differentiated the knowledge levels regarding Inappropriate Touch, with younger children knowing fewer concepts both at pretest and posttest (p = .000). Parallel results apply to the Appropriate Touch subscale (p = .04). CONCLUSIONS The results are consistent with other evaluations of child sexual abuse prevention programs, however the statistically significant though small gains suggest that the programs need to be presented in a more powerful manner.

The ability of elementary school children to learn child sexual abuse prevention concepts

This research was designed to address several of the methodological problems in the current body of knowledge on the efficacy of child abuse prevention programs for elementary school-aged children. A new measure, the Childrens Knowledge of Abuse Questionnaire (C.K.A.Q.) was developed, and its psychometric properties assessed. In total, 400 children were tested in four groups. Half of the sample participated in a child abuse prevention program Touching, and the other half were in a waiting list control group. Half of each group were pretested, and the other half were not, in order to determine whether the pretesting sensitized the students. All children were tested again 5 months afterward to investigate the long-term retention of prevention concepts. Results showed that children who participated in the prevention program scored significantly higher on the C.K.A.Q. than children in the control condition. Age was a critical factor, with significant improvements as age increased between the kindergarten, Grade 1, Grade 3 and Grade 6 students. All participants maintained their level of knowledge after 5 months had passed. The relevance and practical implications which stem from this research are discussed.

Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis

BackgroundIntimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians’ and nurses’ experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development.MethodsPhysicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher’s Exact Test was performed to determine statistical significance when examining nurse/physician differences.ResultsOf the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments.ConclusionsThis research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues.

The efficacy of group treatment for survivors of childhood abuse

OBJECTIVE To assess the effectiveness of a new model of group treatment for sexual abuse survivors over individual therapy alone. METHOD In this quasi-experimental design, 32 women were in either group treatment (N = 22) or a wait-list comparison group (N = 10). They completed standardized measures on depression, self-esteem, and trauma symptomatology at pretest and after completing the 10 to 12 week group. All were in concurrent individual therapy. RESULTS On average, both groups of women decreased depression and trauma symptoms as well as increased self-esteem. However, the clients in the treatment group improved their depression and anxiety to a statistically significantly greater degree than clients in the wait-list comparison condition. Improvement approaching statistical significance was found in levels of self-esteem in the treatment as compared to the wait-list condition. CONCLUSION The group intervention was significantly more effective than individual treatment alone on depression and anxiety. The inclusion of the wait-list comparison group was critical in interpreting the improvement noted by all of the women in treatment.

Children's Reports of Bullying and Safety at School:

The purpose of this research was to determine the frequency of bullying in elementary school children and to examine gender and age differences. A total of 472 students in grades 1-6 in Calgary, Alberta completed a bullying survey. The frequency of bullying was somewhat higher than previously reported by others. In grades 4 to 6,27% experienced both physical and verbal bullying, 21% experienced verbal bullying, and 5% reported physical bullying. Reports of bullying experienced by students in grades I to 3 were similar. Using self-report data from students in grades 4 to 6, a stepwise regression analysis indicated that higher perceived school safety and more teacher support were associated with less verbal bullying. The implications of these findings are discussed below.

Residents' Views of the Efficacy of Shelter Services for Assaulted Women

Although shelters for abused women are common across North America, few have been evaluated. This qualitative study consisted of in-depth interviews with 63 shelter residents. Thirty-five of these women were interviewed in follow-ups 4 to 6 months later. In each interview, they were asked what they found helpful during their shelter stay. Residents were positive about the supportive nature of the staff, safety, relationships with other residents, and the child care. Residents expressed some concerns about the availability of counseling from busy staff and the appropriateness of some shelter residents. Generally, the women endorse shelters as resources that save lives.

Post-Shelter Services: The Efficacy of Follow-Up Programs for Abused Women

Abused women who decide to leave their partners face a number of obstacles, including increased risk of abuse, lack of social support, and difficulty accessing community resources Post-shelter follow-up programs are a new form of intervention designed to provide support and advocacy to women who wish to establish new lives independently from their abusive partner. This article presents evaluations of two such follow-up programs, consisting of both quantitative and qualitative components. Workers provided the demographic characteristics and answered rating scales regarding safety, self-esteem, and use of social supports for 60 women. Standardized measures of social support and perceived stress were completed by a subset of 28 women when they entered the programs and 3 months later. The women significantly improved their amount of appraisal support, although tangible and belonging support and perceived stress levels did not change significantly. Self-esteem improved significantly for another subset of 12 follow-up program clients. In-depth interviews with 31 of the women identified problematic issues with which the clients reported receiving support from the follow-up program. Clients also outlined their views of the strengths and limitations of the programs. The majority of the women perceived the programs as central in their not returning to an abusive relationship.

What Children Learn from Sexual Abuse Prevention Programs: Difficult Concepts and Developmental Issues

Objective Social workers have long been concerned about whether child-directed school-based programs are effective in preventing sexual abuse. Knowing childrens prior knowledge of abuse prevention concepts and what changes after intervention would be invaluable to program personnel. Method This secondary analysis involved 231 elementary school children who were randomly assigned (matched by age) to participate in the “Who Do You Tell” sexual abuse prevention program (n = 117) or in a wait-list control condition (n = 114). Chi-square analyses compared changes on each item of the Childrens Knowledge of Abuse Questionnaire-Revised based on treatment versus control condition and developmental level (ages 5 to 7 compared to ages 8 to 13). Results Three items significantly improved for children in the program as compared to those in the control condition across ages. Conclusions The results suggest several changes in teaching prevention concepts.

Developmental issues in young children's learning of sexual abuse prevention concepts

This research is an item analysis of a measure of knowledge of sexual abuse prevention concepts, the Childrens Knowledge of Abuse Questionnaire (C.K.A.Q.), which was utilized in an evaluation of an elementary school program. The literature review highlights developmental theories that distinguish between children in Grades 1, 3, and 6 (N = 111). These theories may explain the obtained differences in children of various ages in learning core prevention concepts. The findings are of interest in three ways: inspection of differences in the ease with which the children of each age group responded to specific items even before seeing a prevention program; identification of items in which there was significant improvement after the children participated in the prevention program; and evidence to suggest that children of different ages responded differentially to certain prevention concepts. The implications for the development, presentation and evaluation of child abuse prevention programs are discussed.