|| Child Sexual Abuse: The Initial Effects
|| Beverly Gomes-Schwartz, Jonathan M. Horowitz, and
Albert P. Cardarelli
|| Sage Publications, Inc. © 1990
2111 West Hillcrest Drive
Newbury Park, California 91320
$36.00 (c) / $17.95 (p)
This 205 page book is the report of the research program by
the Family Crisis Program (FCP) for Sexually Abused Children at Tufts New England Medical Center
in Boston. This research, which was funded by the Office of
Juvenile Justice and Delinquency Prevention, had the purpose of providing
services to sexual abuse victims and their families while conducting research on
1) the characteristics of sexually abused children, their families, and social
environment; 2) the nature of the sexual acts these children experienced and the
events that transpired following the disclosure of the abuse; and 3) the effects
of the total experience upon the child and his or her family.
Between July 1980 and January 1982, 314 children were referred
to the FCP for services. Of this initial group, 156 were judged appropriate and
comprised the research sample. The researchers attempted to conduct a
responsible and useful study. They tried to recruit a demographically diverse
and representative sample, used a variety of measures, many standardized with
norms and test validation data, and did an 18-month follow-up.
The book consists of seven chapters describing the project
and the results, with appendices containing the data analyses. The literature on
the effects of sexual abuse is briefly reviewed, and the authors point out when
their results confirm or fail to support popular theories and beliefs.
The research team attempted to screen out false allegations,
which is an improvement over studies in which the sole criterion is
substantiation by social services. The original 314 clients had been handled by
some other agency before referral to FCP, so the most obvious
cases of false allegations were screened out. Out of this group, 115 were not
seen at all, either because they were not appropriate, were referred elsewhere,
or because the family refused services. (Of the families who refused services,
42 did so because they denied that abuse had taken place or that they needed any
services.) Of the 181 children evaluated, abuse could not be substantiated for
25 (14%) after a very thorough evaluation (16 of these were judged to be false
and on the other 9 a determination could not be made). This left a sample of 156
for whom the research team believed sexual abuse was highly likely.
The clinical literature suggests that childhood sexual abuse
is invariably traumatic and causes a wide variety of psychological and
behavioral problems. This belief often results in an immediate referral for
therapy, sometimes even before the abuse is substantiated or before a careful
assessment is done. However, this literature is characterized by an absence of
good research and empirical data. In contrast, the FCP study is one of the first
to use standardized measures with comparisons to general population norms.
results and conclusions, therefore, are important and should be considered
Several of the findings in the FCP project failed to support
common beliefs about sexual abuse. Only 27% of the total sample showed
clinically significant psychopathology. This varied according to the age of the
child with 17% of the preschool children, 40% of the 7 to 13 year olds, and 8%
of the adolescents designated as seriously disturbed. The effects ranged from
the complete absence of symptoms to pervasive and serious problems.
The authors note that it is impossible to determine exactly
how much of the disturbance could be attributed to the sexual abuse since many
of the children came from families with multiple problems. Also, disruption from
the disclosure is likely to have added to any trauma experienced by the
Evaluations at both intake and follow-up indicated that
children who were removed from home because of the abuse were more distressed
than those who remained. Although this may partially be interpreted as
suggesting that the more seriously disturbed children were more likely to be
removed, this finding raises questions about the frequent choice to remove a
child from home when sexual abuse is disclosed. Child protection services were
perceived by families as harmful more often than any other agency involved.
authors recommend that the child be removed only when absolutely necessary to
ensure personal safety.
Another finding which contradicts the common belief is
"The Myth of the Mother as 'Accomplice' to Child Sexual Abuse"
(Chapter 6). The literature consistently pictures the mothers of abuse victims as
emotionally limited women who respond poorly when confronted with abuse
allegations. They are seen as colluding with the offender and are portrayed as
the true culprits when their children are sexually abused. Protective service
workers maintain this belief, which can lead to inappropriate and harmful
interventions when mothers show the slightest tendency to deny the allegations.
However, FCP found that most of the mothers responded
appropriately to the disclosure. Most (90%) demonstrated concern for the child
and more than 80% took action to protect the child. The majority did not have
serious emotional problems. Although some fit the stereotype, it was the
minority of those in the sample.
Although most service providers maintain that intervention is
necessary and counseling the victimized child and the family reduces distress,
the findings on this are not clear. Most of the children showed improvement in
behavioral disturbance and self-esteem at the follow-up, but a no-treatment
control group was not included. Also, some of the children received further
therapy elsewhere after completing the FCP. The authors recommend some type of
immediate intervention but state that with a young child who shows few overt
symptoms, repetitive probing into the details of the sexual experience should be
An unexpected finding was the high percentage of cases (55%)
in which the aggressor used some sort of threat or aggression to gain the
child's compliance. This challenges the notion that most sexual abuse involves
gentle seduction. The most striking finding, according to the authors, was that
family members are just as likely to resort to violence as are unrelated
This is an important study, although there are shortcomings,
acknowledged by the authors. There are no control groups and it is not possible
to draw firm conclusions about cause and effect from the correlational data.
There is little information about fathers. Nevertheless, the research is a great
improvement over the literature which has been based on clinical observations
and case studies and retrospective studies of adults who seek therapy or answer
This book is worth reading.
Reviewed by Hollida Wakefield.