Gestalt play therapy court assessment / Child victim / Sexual crime / Legal professionals / Assessment guideline / Intermediary / Text in Afrikaans / As a source of information the court needs to be convinced of the witness's credibility and the ability to recall and communicate the truth regarding the Incident. Mostly the court uses the expertise of an expert witness to assist it in making a decision regarding the way in which a child needs to testify in court. Experts in this field are challenged to align the legal requirements with those of their field of expertise. In this research the Gestalt therapeutic approach is used to design an assessment guideline to assist experts to assess the ability of child victims of sexual crimes to testify in court. The Gestalt therapeutic approach focuses on the present (here and now) and has the ability to obtain access to the information present in the child's life. In the proposed assessment guideline certain Gestalt play therapy methods are recommended to assist the expert to assessing the child victim of a sexual crime. / Play therapy / M.Diac. (Play therapy)

The urgency of research in the field of child sexual abuse has inspired most efforts to be concentrated on treatment and counselling. An important objective of this study was to show that equal importance should be directed towards the identification, causes, effects and prevention of child sexual abuse. It became evident from the literature study that the catastrophe of child sexual abuse can be reduced if teachers, especially primary school teachers,. are professionally trained to identify, protect, prevent, report, support and guide the sexually abused child or possible victims of child sexual abuse. An empirical study to determine the importance of the role of the primary school teacher in dealing with child sexual abuse has been conducted. The results and the educational implications of the findings are discussed and finally guidelines are given to assist primary school teachers in their task of giving support and guidance to the sexually abused child. / Psychology of Education / M. Ed. (Psychology of Education)

Text in Afrikaans / Hierdie studie ondersoek die bantering van seksueel-gemolesteerde kinders. Die kliniese beeld sowel as die fisiese- en gedragsimptome is kriteria by die uitkenning van seksuele molestering. Die bantering van die seksueel-gemolesteerde kind is medebepalend vir die onmiddellike en langtennyn gevolge van seksuele molestering. Seksuele molestering word vanuit 'n sielkundig-opvoedkundige perspektief bespreek. Die studie neem die seksueel-gemolesteerde kind se betekenisgewing, belewing, betrokkenheid, selfaktualisering en selfkonsep in beskouing. Terapeutiese tegnieke, soos toegepas in gevalle van seksuele molestering, word vir gebruik deur professionele persone en instansies, bespreek. Die empiriese ondersoek fokus op die houdinge, hanteringswyses en toepassing van terapeutiese tegnieke deur professionele persone en instansies in die Witbank omgewing. Volgens die navorsingsresultate is daar geen uniforme hanteringswyse of riglyne vir terapie ten opsigte van seksueel-gemolesteerde kinders nie. Die navorsing toon verder swak interinstansie-samewerking wat die voordele van uniforme hanteringswyses en riglyne vir terapie emstig aan bande le / This study investigates the treatment of sexually-abused children. The clinical framework and the physical and behavioural symptoms being some of the criteria utilised to identify such children. The methods used to treat cases co-determine the immediate and long-term effects of sexual abuse. Sexual abuse is discussed from an educational-psychological perspective. The study reflects on the child's meanin& experiencing, involvement, selfactualisation, self-concept and their effects on her life. Professional approaches, therapeutic techniques and treatments are described for use by professionals and agencies, based on an empirical investigation conducted in Witbank. The results of the research indicate a non-uniform approach in guidelines used for therapeutic techniques and the treatment of sexually-abused children. The research shows further that interaction between professional bodies and -individuals in treatment of these cases is poor and the benefits that should result from uniform treatment are therefore severely limited / Psychology of Education / M. Ed. (Spesialisering in Voorligting)

Summary in English / Text in Afrikaans / Awareness of and interest in the incidence of sexual child abuse has been increasing. The current prominence of this phenomenon in south Africa, . is evidenced by reports in the printed and electronic media. A study of the prehistoric era, ancient civilizations, the Middle Ages and the Renaissance and later shows that children have been sexua·lly abused throughout all ages. Yet, the sexual abuse of children is incompatible with the values and goals of authentic nurturing. i • Child sexuality can never ~e equated w1.th adult I sexuality. The child lacks the emotional~ mental, intellectual and physical capabilities to manage sexual contact with an adult person. He/ she is therefore not in a position to agree to intimate intercourse. This research project mainly focused on the relationship between the identification of and aid to the sexually abused child, and the personality functioning of adults who were sexually abused as children. An ontological-antropological approach to childhood has shown that the sexually abused child has the right to the school guidance teacher's respect for his dignity as child and a need for a response to his pain and yearning. The sexually abused child is situated in a distinctive lifeworld and sexual abuse has affective, social and physical consequences. Social relations are negatively affected and some children show self-destructive behavior. The establishment of an authentic and stable sexual identity is especially threatened. Children should be educated to resist the sexual advances of adults, while sexually abused children should be provided with adequate aid. Educators (guidance teachers) should therefore have the necessary guidelines at their disposal for the prevention and treatment of sexual child abuse. / Psychology of Education / D.Ed. (Psychology of Education)

published_or_final_version / Education / Master / Master of Education

The purpose of this study was to determine the extent, pattern and forms of child sexual abuse amongst university students / to investigate the degree of sexual coercion / to examine victim-perpetrator relationships / to determine the extent to which students are bothered by the event at the time of completing the Early Sexual Experiences Checklist / to establish the age of the student at the time the event occurred and also the age of the other person involved when the event occurred / and to determine the frequency of the coercive event.

Childhood abuse, whether physical or sexual, is a major public health issue. The most recent United States data from Child Protective Services (CPS) show that in 2013 there were 3.5 million referrals of child maltreatment involving 6.4 million children. Out of these cases, 18% were for physical abuse and 9% were for sexual abuse. However, researchers argue that CPS data grossly underestimate the prevalence of childhood abuse as most childhood abuse goes unreported. Indeed, to date, the true prevalence of childhood abuse remains unknown as research has been hampered by inconsistent definitions of abuse and wide variation in methodologies including measures for its identification and modes of administration of these measures. Although a health care visit presents an opportunity to identify a childhood abuse history, health care providers frequently fail to ask about it. The reasons doctors give for not asking about abuse include lack of training, not knowing how to ask, and lack of familiarity with practical methods for screening that can be used in primary care settings. There is little to no research on effective means for identifying childhood abuse histories, especially in the adolescent and young adult population, or on how different modes of administration of screens to identify childhood abuse compare to each other. The net result is that most childhood physical and sexual abuse is never identified and many victims do not get the needed services to help them heal. When unaddressed, childhood abuse has negative impacts on victims’ health and wellbeing over the life course. Prior studies of adults show that when compared with non-victims of abuse, victims tend to perceive their health as poorer and utilize more health care services including emergency room and urgent outpatient care. These studies also suggest that adult victims use less routine and preventive care than non-victims. Only two studies, conducted among widely different adolescent populations, have examined how adolescent victims perceive their health. Similarly, limited evidence examining perception of health is available for young adults. These studies found that victims perceive their health as poorer than non-victims. There have been no adolescent-specific studies of how victimization impacts adolescents’ utilization of health care. One study includes participants ages 15 to 98 years and only two studies focusing on this issue in samples primarily of young adults attending college have been published. These studies found that victims utilize more health care than non-victims. Therefore, we lack a sufficient body of evidence to come to clear conclusions of how childhood abuse affects self-perceived health in adolescents and young adults. The general lack of evidence about both how childhood abuse impacts perception of health and utilization of health care in adolescents and young adults indicates a need for further study. Given that little is known about how to best identify an abuse history in adolescents and young adults and the impact of abuse on perception of health and utilization of health care, this dissertation pursued three aims: (1) to review the literature comparing modes of administration of screens to identify adolescent and young adult victims of childhood physical and sexual abuse; (2) to investigate how different modes of administration of screens to identify adolescent and young adult victims of childhood physical abuse within a primary care health setting compare to each other, and; (3) to examine the association of a history of childhood abuse (defined as none, physical only, and sexual with or without physical) with perceived health status and the health care utilization patterns among adolescents and young adults. For aim 1, a comprehensive literature review was conducted via PubMed of studies, published between January 1st, 1994 and December 31st, 2014 that compared modes of administration of screens to identify a history of childhood physical and sexual abuse in adolescents and young adults. Only one study was found. This study compared paper and pencil questionnaire, computer assisted survey, and face to face structured interview in the identification of childhood physical and sexual abuse among young adults in a college setting. No significant difference in the proportion of childhood physical abuse or childhood sexual abuse was identified by mode of administration. The identification through this search of only one study – which was conducted among college students, with no studies done among adolescents – shows a significant gap in our knowledge regarding this issue. Given that understanding how to identify childhood abuse is a critical issue, this gap is disturbing and underscores the need for studies of identification of childhood abuse to be a research priority. For aim 2, a sample of participants, ages 12-24 years, receiving health services at the Mount Sinai Adolescent Health Center in New York City were randomized to one of four modes of administration to identify a history of childhood physical abuse. The four modes of administration of screens to identify childhood abuse were paper and pencil screen, Audio Computer Assisted Self Interview screen (ACASI), face to face structured screen and face to face unstructured interview. The full sample also completed measures to assess demographic characteristics and to screen for depression symptoms. Of the sample, 44.5% of the participants disclosed childhood physical abuse. There was a statistically significant difference in the proportion of childhood physical abuse identified according to mode of administration: face to face unstructured interview identified the highest proportion of childhood physical abuse victims, followed by face to face structured screen. After adjusting for age, gender, race/ethnicity, depression, living arrangement and last grade completed, the odds of identifying physical abuse was 1.6 (95%CI: 1.0, 2.7) and 4.5 (95%CI: 2.6, 7.8) greater for face to face structured screen and for face to face unstructured interview, respectively as compared to paper and pencil screen. ACASI and paper and pencil were similar to each other but inferior to the face to face methods. For aim 3, in addition to what was measured for aim 2, the sample completed measures on a history of childhood sexual abuse and perceived health and health care utilization. The sample was then categorized into three groups: no abuse, physical abuse only, and sexual abuse with or without physical abuse. The association of childhood abuse status with perceived health and health care utilization were examined. There was no statistical significant association between a history of childhood abuse status and perceived health. However, the odds of reporting a fair/poor perception of health among those reporting childhood abuse were at least 40% lower regardless of whether the abuse was physical (OR: 0.60; 95%CI: 0.3,1.2) or sexual (OR: 0.50; 95%CI: 0.2,1.1). No significant association was found between childhood abuse status and health care utilization. However, the odds of victims reporting using urgent care only versus routine care only were at least 10% lower regardless of whether the abuse was physical (OR: 0.50; 95%CI: 0.3, 1.1) or sexual (OR: 0.90; 95%CI: 0.4,1.9). The odds of reporting using both urgent and routine care versus routine care only was similar between victims and non-victims for physical abuse (OR: 1.0; 95%CI: 0.6, 1.5) and was 30% higher for victims of sexual abuse (OR: 1.3; 95%CI: 0.8, 2.2). The findings from the three aims examined identified significant gaps in our knowledge on childhood abuse among adolescents and young adults suggesting an urgent need for further research. While much research has focused on the impact of childhood abuse on health and well-being, aim 1 reveals that little is known about which mode of administration of screens to identify childhood abuse is most effective in the identification of childhood abuse in adolescent and young adults. Furthermore, we know even less about what modes of administration of screens might be practical in primary care settings, or what must be done to improve the level of screening for childhood abuse by physicians and other health care providers. Although the findings from aim 2 suggest that face to face modes of administration are most effective in screening for childhood physical abuse in primary care settings, further studies are needed to support these findings. In addition, there is a need for studies that examine what are the best methods to use to identify childhood sexual abuse in primary care settings. The findings from aim 3 suggest that adolescents and young adults with a history of childhood physical and sexual abuse, receiving health care at the Mount Sinai Adolescent Health Center, do not perceive their health as worse than non-victims nor do they appear to utilize health care differently from non-victims. These findings contrast with results from prior studies of perceived health status and health care utilization among adolescents and young adult childhood abuse victims. Understanding how abuse impacts both the perception of health and health care utilization will be crucial in the development of interventions to identify and support adolescent and young adult victims of childhood physical and sexual abuse.

This study examined the association between poverty and child neglect. The existence of a general association has been established for some time. However, there is much debate, and little detailed research, on the specific processes that create this association. This study focused on the form of neglect that involves the most health risk for children—physical neglect. It was hypothesized that poverty should increase the likelihood of a specific type of physical neglect, neglect of safety and basic needs, occurring more than other types. Using official child protective services data from a national data set three types of physical neglect were examined: abandonment, lack of safety or basic needs, and inadequate supervision. Hypothesis 1 was that poverty increases the odds of safety/basic needs neglect more than it influences the odds of either abandonment neglect or inadequate supervision neglect, controlling for prior neglect. Hypothesis 2 focused on a test of whether the link between poverty and physical neglect is not direct, but is instead mediated by caregiver stress. Three waves of longitudinal data were used for this test to establish causal time order between poverty and stress, and between stress and physical neglect. This study analyzed data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), Assessments 0-3 from the National Data Archive on Child Abuse and Neglect at Cornell University. The data was analyzed using multinominal logistic regression for both models. The results did not confirm Hypothesis 1, though the analysis was limited somewhat due to low frequencies of some physical neglect types in certain age groups. Hypothesis 2 was confirmed showing that the effect of poverty on physical neglect was completely mediated by caregiver stress for the abandonment and safety/basic needs types of physical neglect. Implications of the results for research on the effects of poverty on child neglect, and for preventing child neglect are discussed. / Graduation date: 2012

The purpose of this study was to determine the extent, pattern and forms of child sexual abuse amongst university students / to investigate the degree of sexual coercion / to examine victim-perpetrator relationships / to determine the extent to which students are bothered by the event at the time of completing the Early Sexual Experiences Checklist / to establish the age of the student at the time the event occurred and also the age of the other person involved when the event occurred / and to determine the frequency of the coercive event.

The purpose was to give a theoretical perspective on domestic violence in middle-childhood. The aim was therefor to explore and describe domestic violence in middle-childhood from a Gestalt perspective with guidelines for play therapists to utilise with middle-childhood children experiencing domestic violence. Due to the nature of qualitative research triangulation was used where firstly an in-depth literature study on middle-childhood, the Gestalt approach and domestic violence. Secondly semi-structured interviews in the empirical research in example a self-developed questionnaire. Together with this mediums and techniques of Gestalt play therapy for the main purpose of obtaining more information from the respondents. The literature was utilised from a explorative and descriptive nature of the research to refine concepts through semi-structured interviews with six children as respondents. This information is given graphically and applied for guidelines from Gestalt perspective to play therapists to assist these children. The objectives of the study have thus being achieved. / Philosophy, Practical and Systematic Theology / M. Diac.