Luísa Fernanda Habigzang

Abuso sexual infantil e dinâmica familiar: aspectos observados em processos jurídicos

The sexual abuse of children is a public health issue, due to the high epidemic incidence and to the serious damages for the victimsx92 development. The dynamic of this kind of violence is complex, involving psychological, social and legal aspects. This work maps the risk factors for intrafamiliar sexual abuse, identified in the juridical processes of the public prosecution service of Rio Grande do Sul - Brazil, during the period between 1992 and 1998. The analysis of 71 files shows the victimsx92 profile and the characterization of the perpetrators, of the families and of sexual violence event. The results point that the unemployment, reconstituted families, alcohol and drug abuse, economical difficulties and other kinds of violence constituted the main risk factors associated to the sexual abuse. Such results can subsidize preventive and therapeutic actions against children and adolescents sexual violence.

Fatores de risco e de proteção na rede de atendimento a crianças e adolescentes vítimas de violência sexual

Sexual violence against children and adolescences is a public health concern, characterized by a complex dynamics, which involves psychological, social and legal aspects, demanding the coordinated intervention of different institutions. This study presents the mapping of risk and protective factors in resource network for children and adolescences victims of sexual violence, who were identified in the 1992-1998 judicial processes of the Ministerio Publico (District Attorneys Office) of the state of Rio Grande do Sul, Brazil. The analysis of 71 files present the interventions that were performed by the institutions that composed the network. The results pointed out the difficulty of the protection services to intervene in the cases. The lack of communication among the institutions to articulate the necessary protection measures and to follow-up on their implementation was verified. These results suggest the need to qualify the services of the network, seeking the real understanding of the cases, as well as performing appropriate interventions.

Avaliação psicológica em casos de abuso sexual na infância e adolescência

A avaliacao psicologica de criancas e adolescentes vitimas de abuso sexual e um desafio para os profissionais, devido a complexidade do fenomeno. O presente artigo tem como objetivo apresentar os resultados de um modelo de avaliacao psicologica. O estudo foi realizado com 10 meninas com idade entre nove e 13 anos. As participantes foram clinicamente avaliadas em tres encontros individuais. Os resultados apontaram que a maioria das meninas foi vitima de abuso sexual por pelo um ano ate revelarem a situacao a alguem. As meninas apresentaram sintomas de transtorno do estresse pos-traumatico, depressao e ansiedade. O metodo de avaliacao utilizado mostrou-se efetivo, possibilitando a formacao de vinculo, o conhecimento da historia do abuso sexual e a identificacao dos sintomas psicologicos decorrentes.

Grupoterapia cognitivo-comportamental para crianças e adolescentes vítimas de abuso sexual

OBJECTIVEnTo assess the effects of a cognitive behavioral group therapy model among female children and adolescents victims of sexual abuse.nnnMETHODSnA non-randomized study with intragroup comparisons over time was carried out. Female children and teenagers from nine to 16 years of age (N=40) were clinically assessed in three individual meetings in the metropolitan area of Porto Alegre, Southern Brazil, between 2006 and 2008. The group therapy comprised 16 semi-structured sessions. Psychological instruments were applied to investigate symptoms of anxiety, depression, post-traumatic stress disorder, child stress, beliefs and perception of the abuse experience before, during and after the intervention. The results were analyzed through statistical tests for repeated measures. A comparative analysis was carried out with the results of the pretest between the groups that received group psychotherapy immediately after the sexual abuse was reported and those who were waiting for psychological support.nnnRESULTSnThe assessment of the impact of the intervention revealed that cognitive behavioral group therapy significantly reduced symptoms of depression, anxiety, child stress and post-traumatic stress disorder. In addition, the intervention enabled the participants to modify beliefs of guilt, low degrees of trust and credibility, and was effective in reducing psychological symptoms and changing distorted beliefs and perception in regard to the abuse.nnnCONCLUSIONSnCognitive behavioral group therapy was effective in reducing psychological symptoms in sexually abused girls.OBJETIVO: Avaliar os efeitos do modelo de grupoterapia cognitivo-comportamental para criancas e adolescentes do sexo feminino vitimas de abuso sexual. METODOS: Foi utilizado delineamento nao-randomizado intragrupos de series temporais. Criancas e adolescentes do sexo feminino com idade entre nove e 16 anos (N=40) da regiao metropolitana de Porto Alegre (RS), foram clinicamente avaliadas em tres encontros individuais, de 2006 a 2008. A grupoterapia consistiu de 16 sessoes semi-estruturadas. Instrumentos psicologicos investigaram sintomas de ansiedade, depressao, transtorno do estresse pos-traumatico, stress infantil e crencas e percepcoes da crianca em relacao a experiencia abusiva antes, durante e apos a intervencao. Os resultados foram analisados por meio de testes estatisticos para medidas repetidas. Foi realizada uma analise comparativa dos resultados do pre-teste entre os grupos que receberam atendimento psicologico em grupo imediato apos a denuncia do abuso e aquelas que aguardaram por atendimento. RESULTADOS: A analise do impacto da intervencao revelou que a grupoterapia cognitivo-comportamental reduziu significativamente sintomas de depressao, ansiedade, stress infantil e transtorno do estresse pos-traumatico. Alem disso, a intervencao contribuiu para a reestruturacao de crencas de culpa, baixa confianca e credibilidade, sendo efetivo para a reducao de sintomas psicologicos e alteracao de crencas e percepcoes distorcidas sobre o abuso. CONCLUSOES: A grupoterapia cognitivo-comportamental mostrou ser efetiva para a reducao de sintomas psicologicos de criancas e adolescentes vitimas de abuso sexual.

Avaliação de processo e resultado em psicoterapias : uma revisão

*# ¶ ae RESUMO. A avaliacao em psicoterapia constitui um desafio para pesquisadores e clinicos. Esta revisao critica sobre possibilidades de avaliacao de processo e resultado em psicoterapia estimula o debate sobre a incorporacao da pratica clinica baseada em evidencias como meio de obter informacao cientifica quanto a adequacao da intervencao terapeutica. Atraves de estudos sobre a avaliacao do processo psicoterapico e possivel elucidar conexoes entre o tratamento psicologico e seus efeitos. Desta forma, torna-se possivel identificar mecanismos de acao terapeutica e estrategias que podem potencializar o processo de mudanca. Este debate podera favorecer a aproximacao entre pesquisa e pratica clinica. Identificar variaveis das quais pode depender a eficacia/efetividade do tratamento psicoterapico repercute no aprimoramento do treinamento de psicologos em formacao e no delineamento de intervencoes custo-efetivas. Palavras-chave : Tratamento psicoterapico, eficacia e efetividade, pratica baseada em evidencia. ASSESSMENT OF PSYCHOTHERAPY PROCESS AND OUTCOME: A REVIEWAssessment of psychotherapy is a challenge to both researchers and clinical psychologists. This critical review about assessment of process and outcomes in psychotherapy stimulates the debate on how evidence-based clinical practice can provide scientific information about the relationship between therapeutic intervention and clinical outcome. This allows to identify therapeutic mechanisms and strategies to enhance the process of change in psychotherapy. This debate might narrow the gap between research and clinical practice. The improvement on clinical psychology training and the choice of costeffective interventions might depend on the identification of variables that influence efficacy and effectiveness of psychotherapy.

A revelação de abuso sexual: as medidas adotadas pela rede de apoio

This study aimed to identify the measures adopted by the social and emotional support network of children and adolescents after disclosure of sexual abuse. Forty victims of sexual abuse, eight to sixteen years old girls, responded to an interview that mapped the measures adopted by the network. Disclosure to the parents took place in 42.5% of the cases, and 92.5% of the parents believed it to be true. 35% of the girls went to a shelter home and the rest remained with the family after exclusion of the aggressor. The trustworthiness of the family in disclosure and reporting of violence was a protective factor. However, the high shelter rate and absence of effective monitoring of the aggressor removal were risk factors.

Violência sexual contra meninos: dados epidemiológicos, características e consequências

This theoretical essay provides information about sexual violence against males in Brazil, given the scarcity of national studies on the subject. This lack of theoretical and practical knowledge creates challenges for professional work. Searching the national databases of scientific research revealed only one study, so international publications were employed. This study examines epidemiological data about sexual violence against males in Brazil as well as the characteristics of the victims, authors, and situations of sexual violence. This essay also considers the possible consequences of this type of violence. The found literature often discusses the difficulties boys have in reporting their experiences of sexual abuse, as well as their doubts about their sexual orientation. In conclusion, although sexual violence against males is less frequent, it does occur and thus requires preventative and therapeutic strategies. Furthermore, more national studies on this topic must be made.O objetivo desse ensaio teorico e contribuir para a producao de conhecimento sobre a violencia sexual masculina no Brasil, tendo em vista a escassez de estudos nacionais. A carencia de conhecimento teorico-pratico torna a atuacao profissional um desafio. Buscaram-se trabalhos cientificos em bases de dados nacionais, porem apenas um estudo foi encontrado. Diante disso, recorreu-se a publicacoes internacionais. Dados epidemiologicos da violencia sexual masculina no Brasil, bem como as caracteristicas das vitimas, dos autores e das situacoes de violencia sexual, alem das possiveis consequencias deste tipo de violencia, foram conteudos abordados nesse estudo. A dificuldade dos meninos em relatar suas experiencias de violencia sexual e as duvidas quanto a orientacao sexual sao aspectos frequentes na discussao da literatura encontrada. Conclui-se que, embora em menor prevalencia, a violencia sexual masculina ocorre e necessita de estrategias preventivas e terapeuticas. Alem disso, e necessario o incremento de estudos nacionais sobre a tematica.

Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended. The model proved effective for treating young female victims of sexual abuse.

Cognitive behavioral group therapy for sexually abused girls

OBJECTIVEnTo assess the effects of a cognitive behavioral group therapy model among female children and adolescents victims of sexual abuse.nnnMETHODSnA non-randomized study with intragroup comparisons over time was carried out. Female children and teenagers from nine to 16 years of age (N=40) were clinically assessed in three individual meetings in the metropolitan area of Porto Alegre, Southern Brazil, between 2006 and 2008. The group therapy comprised 16 semi-structured sessions. Psychological instruments were applied to investigate symptoms of anxiety, depression, post-traumatic stress disorder, child stress, beliefs and perception of the abuse experience before, during and after the intervention. The results were analyzed through statistical tests for repeated measures. A comparative analysis was carried out with the results of the pretest between the groups that received group psychotherapy immediately after the sexual abuse was reported and those who were waiting for psychological support.nnnRESULTSnThe assessment of the impact of the intervention revealed that cognitive behavioral group therapy significantly reduced symptoms of depression, anxiety, child stress and post-traumatic stress disorder. In addition, the intervention enabled the participants to modify beliefs of guilt, low degrees of trust and credibility, and was effective in reducing psychological symptoms and changing distorted beliefs and perception in regard to the abuse.nnnCONCLUSIONSnCognitive behavioral group therapy was effective in reducing psychological symptoms in sexually abused girls.OBJETIVO: Avaliar os efeitos do modelo de grupoterapia cognitivo-comportamental para criancas e adolescentes do sexo feminino vitimas de abuso sexual. METODOS: Foi utilizado delineamento nao-randomizado intragrupos de series temporais. Criancas e adolescentes do sexo feminino com idade entre nove e 16 anos (N=40) da regiao metropolitana de Porto Alegre (RS), foram clinicamente avaliadas em tres encontros individuais, de 2006 a 2008. A grupoterapia consistiu de 16 sessoes semi-estruturadas. Instrumentos psicologicos investigaram sintomas de ansiedade, depressao, transtorno do estresse pos-traumatico, stress infantil e crencas e percepcoes da crianca em relacao a experiencia abusiva antes, durante e apos a intervencao. Os resultados foram analisados por meio de testes estatisticos para medidas repetidas. Foi realizada uma analise comparativa dos resultados do pre-teste entre os grupos que receberam atendimento psicologico em grupo imediato apos a denuncia do abuso e aquelas que aguardaram por atendimento. RESULTADOS: A analise do impacto da intervencao revelou que a grupoterapia cognitivo-comportamental reduziu significativamente sintomas de depressao, ansiedade, stress infantil e transtorno do estresse pos-traumatico. Alem disso, a intervencao contribuiu para a reestruturacao de crencas de culpa, baixa confianca e credibilidade, sendo efetivo para a reducao de sintomas psicologicos e alteracao de crencas e percepcoes distorcidas sobre o abuso. CONCLUSOES: A grupoterapia cognitivo-comportamental mostrou ser efetiva para a reducao de sintomas psicologicos de criancas e adolescentes vitimas de abuso sexual.

Documentary analysis of cases of sexual violence against boys reported in Porto Alegre

A violencia sexual (VS) contra meninos e um tema sobre o qual ha poucas pesquisas no Brasil. Diante disto, objetivou-se investigar os casos notificados na Coordenadoria Geral de Vigilância em Saude de Porto Alegre (CGSV POA) entre 2009 e 2011. Foram analisadas descritivamente 239 fichas quanto a: caracteristicas das vitimas (i.e, idade, cor, escolaridade, deficiencia, consequencias da VS); da VS (i.e., ano de ocorrencia e de notificacao, estabelecimento notificador, âmbito, local de ocorrencia, tipo de VS, ocorrencia de penetracao, numero de episodios, outras formas de violencia, numero de agressores, classificacao final – confirmado ou nao – e encaminhamentos); e dos agressores (i.e., sexo, relacao com a vitima, uso de alcool/drogas). Houve predominância de meninos entre sete e 12 anos, brancos, vitimas de SV intrafamiliar em dois ou mais episodios, perpetrada por agressores do sexo masculino. Tais resultados podem ser utilizados no planejamento de intervencoes preventivas e terapeuticas especificas para meninos vitimas de VS.