Vil Du?! incorporation of a serious game in therapy for sexually abused children and adolescents

Abstract Background Talking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame. The serious game Vil Du?! was developed to help children open up about sexual experiences. Vil Du?! is a non-verbal communication game, which resembles a dress-up game, in which children can show the therapist what happened to them. The current study examined how and for which therapy components Vil Du?! was used by therapists. Methods We used a mixed-methods triangulation design. Therapists filled out online surveys about the use of Vil Du?! with 23 clients (Mage = 11.38 years, SD = 3.96; 61 % female). We also conducted semi-structured interviews with 10 therapists. The data were analyzed in SPSS (quantitative) and Nvivo (qualitative) following the stepwise guidelines of Zhang and Wildemuth. Results Merged qualitative and quantitative data revealed that therapists acknowledged the usefulness of Vil Du?! mostly for the therapy components trauma narration and processing, and psycho-education about sexuality. In addition, Vil Du?! might be most useful for clients who have difficulty with disclosing sexual abuse experiences, due to limited verbal abilities or feelings of guilt, shame, avoidance, and tension. Conclusions Recommendations from this study were incorporated in a user manual as a first step toward more systematic and broad implementation of Vil Du?! in the treatment of young sexual abuse victims. A next step is to test whether implementing Vil Du?! in therapy is effective in reducing the negative mental health consequences of sexual abuse for children and adolescents.

Download Full-text

Medical Evaluation of Sexually Abused Children: A Review of 311 Cases

PEDIATRICS ◽

10.1542/peds.69.1.8 ◽

1982 ◽

Vol 69 (1) ◽

pp. 8-14

Author(s):

Mary Ellen Rimsza ◽

Elaine H. Niggemann

Keyword(s):

Sexual Abuse ◽

Physical Examination ◽

Children And Adolescents ◽

Sexually Abused ◽

Abused Children ◽

Medical Evaluation ◽

Time Period ◽

Victims Of Sexual Abuse ◽

Sexually Abused Children

The case records of 311 children and adolescents who were medically evaluated for sexual abuse are reviewed. Only 18% of these victims were assaulted by strangers; 131 of the assailants were relatives. Thirty percent of the victims reported multiple assaults over a time period of one week to nine years. Physical examination showed no abnormalities in only 23% of the patients. Twenty-one patients had gonorrhea and seven patients were pregnant. Guidelines for the medical evaluation of patients suspected to be victims of sexual abuse are discussed.

Download Full-text

A Therapeutic Game for Sexually Abused Children and Adolescents (Vil Du?!): Exploratory Mixed Methods Evaluation

JMIR Serious Games ◽

10.2196/26062 ◽

2021 ◽

Vol 9 (3) ◽

pp. e26062

Author(s):

Joyce Johanna Endendijk ◽

Henny Tichelaar ◽

Menno Deen ◽

Maja Deković

Keyword(s):

Sexual Abuse ◽

Children And Adolescents ◽

Sexually Abused ◽

Evaluation Study ◽

Web Based ◽

Self Blame ◽

Mixed Methods Evaluation ◽

Therapeutic Game ◽

Semistructured Interviews ◽

Sexually Abused Children

Background Talking about experiences of sexual abuse in therapy is difficult for children and adolescents. Possible reasons for this difficulty are a lack of vocabulary to describe the situation or feelings of shame, fear, and self-blame associated with sexual abuse. The serious game Vil Du?! was developed to help children open up about their sexual abuse experiences. Vil Du?! is a nonverbal communication game that resembles a dress-up game in which children can show the therapist what happened to them. Objective This exploratory evaluation study examines which working elements of the game could be identified in therapy with victims of sexual abuse (aim 1). In addition, this study examines how therapists evaluate the acceptability of the game (aim 2). Methods The therapists completed 23 web-based surveys on the use of Vil Du?! In addition, semistructured interviews were conducted with 10 therapists. The data were analyzed in NVivo following previously reported stepwise guidelines. Results Regarding aim 1, therapists mentioned various working elements of Vil Du?!; for instance, Vil Du?! puts the child in control of the situation. In addition, Vil Du?! reduces barriers to disclosure because there is no need to talk or have eye contact with the therapist. Regarding aim 2, Vil Du?! was generally evaluated more positively than negatively by the therapists. For instance, therapists indicated that using Vil Du?! is time efficient and might make the treatment process less confronting and difficult for the client. According to therapists, most clients indeed experienced less tension and more positive (or neutral) emotions than negative emotions when using Vil Du?! Conclusions The most important working elements of Vil Du?!, according to therapists, are that it enables children to regain control over their sexual abuse experiences and reduces barriers to disclosing sexual abuse experiences. The more positive evaluation of Vil Du?! indicates the acceptability of the game for therapists as well as their clients.

Download Full-text

Child sexual abuse: the perception of mothers concerning their daughters' sexual abuse

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692009000400011 ◽

2009 ◽

Vol 17 (4) ◽

pp. 501-506 ◽

Cited By ~ 6

Author(s):

Quitéria Clarice Magalhães Carvalho ◽

Marli Teresinha Gimeniz Galvão ◽

Maria Vera Lúcia Moreira Leitão Cardoso

Keyword(s):

Domestic Violence ◽

Sexual Abuse ◽

Child Sexual Abuse ◽

Qualitative Study ◽

Sexually Abused ◽

Structured Interviews ◽

Abused Children ◽

The Subject ◽

Sexually Abused Children

Domestic violence affects all members in a family and children are considered the main victims. This qualitative study aimed to grasp the perception of mothers whose daughters were sexually abused. Data were collected between February and March 2007 in a governmental facility in Fortaleza-CE, Brazil through semi-structured interviews with ten mothers of sexually abused children. Data were submitted to the Collective Subject Discourse Technique from which three themes emerged: Guilt is rooted in the motherhood myth, unhealable pain and despair as a consequence of a feeling of powerlessness. Results evidenced that mothers experience a range of feelings in which pain, revulsion and powerlessness are highlighted. Society should be engaged in the subject and interested in understanding violence, its magnitude and the whole affected chain, otherwise, only good intentions will remain, lost in the void from the lack of action.

Download Full-text

Therapeutic Practices for Sexually Abused Children and Adolescents: Resources for Marriage, Family, and Couples’ Counselors

The Family Journal ◽

10.1177/1066480719844017 ◽

2019 ◽

Vol 27 (4) ◽

pp. 359-365

Author(s):

James M. Devlin ◽

Lisa Hill ◽

Jordan Berry ◽

Kerri Felder ◽

Clara Wilson

Keyword(s):

Sexual Abuse ◽

Children And Adolescents ◽

Sexually Abused ◽

Behavioral Therapy ◽

Treatment Options ◽

Future Research ◽

Long Term Effects ◽

Abused Children ◽

Effects Of Sexual Abuse ◽

Sexually Abused Children

Marriage, family, and couple counselors should be educated in various treatment options for sexually abused adolescents, due to the frequency, and severity of this form of abuse. The long-term effects of sexual abuse can be devastating for victims. Posttraumatic stress disorder, anxiety, and depression are potential issues resulting from sexual abuse. The present review analyzes three different therapeutic approaches family counselors may use for working with sexually abused children and adolescents. These approaches include trauma-focused-cognitive behavioral therapy, play therapy and expressive art therapy, eye movement and desensitization, and reprocessing therapy. Implications for family, marriage, and couples’ counselors are provided recommendations as well for future research.

Download Full-text

A Therapeutic Game for Sexually Abused Children and Adolescents (Vil Du?!): Exploratory Mixed Methods Evaluation (Preprint)

10.2196/preprints.26062 ◽

2020 ◽

Author(s):

Joyce Johanna Endendijk ◽

Henny Tichelaar ◽

Menno Deen ◽

Maja Deković

Keyword(s):

Sexual Abuse ◽

Children And Adolescents ◽

Sexually Abused ◽

Evaluation Study ◽

Web Based ◽

Self Blame ◽

Mixed Methods Evaluation ◽

Therapeutic Game ◽

Semistructured Interviews ◽

Sexually Abused Children

BACKGROUND Talking about experiences of sexual abuse in therapy is difficult for children and adolescents. Possible reasons for this difficulty are a lack of vocabulary to describe the situation or feelings of shame, fear, and self-blame associated with sexual abuse. The serious game Vil Du?! was developed to help children open up about their sexual abuse experiences. Vil Du?! is a nonverbal communication game that resembles a dress-up game in which children can show the therapist what happened to them. OBJECTIVE This exploratory evaluation study examines which working elements of the game could be identified in therapy with victims of sexual abuse (aim 1). In addition, this study examines how therapists evaluate the acceptability of the game (aim 2). METHODS The therapists completed 23 web-based surveys on the use of Vil Du?! In addition, semistructured interviews were conducted with 10 therapists. The data were analyzed in NVivo following previously reported stepwise guidelines. RESULTS Regarding aim 1, therapists mentioned various working elements of Vil Du?!; for instance, Vil Du?! puts the child in control of the situation. In addition, Vil Du?! reduces barriers to disclosure because there is no need to talk or have eye contact with the therapist. Regarding aim 2, Vil Du?! was generally evaluated more positively than negatively by the therapists. For instance, therapists indicated that using Vil Du?! is time efficient and might make the treatment process less confronting and difficult for the client. According to therapists, most clients indeed experienced less tension and more positive (or neutral) emotions than negative emotions when using Vil Du?! CONCLUSIONS The most important working elements of Vil Du?!, according to therapists, are that it enables children to regain control over their sexual abuse experiences and reduces barriers to disclosing sexual abuse experiences. The more positive evaluation of Vil Du?! indicates the acceptability of the game for therapists as well as their clients.

Download Full-text

Does Sexual Abuse Disclosure Predict Sexual Behavior Problems in Sexually Abused Children?

PsycEXTRA Dataset ◽

10.1037/e517292011-790 ◽

2009 ◽

Author(s):

Marielle Falki ◽

Nicholas Bishop ◽

Danielle Louis ◽

Natalie Wilcox

Keyword(s):

Sexual Abuse ◽

Sexual Behavior ◽

Behavior Problems ◽

Sexually Abused ◽

Sexual Behavior Problems ◽

Abused Children ◽

Abuse Disclosure ◽

Sexual Abuse Disclosure ◽

Sexually Abused Children

Download Full-text

Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

Journal of Interpersonal Violence ◽

10.1177/08862605211013963 ◽

2021 ◽

pp. 088626052110139

Author(s):

Rachel Langevin ◽

Martine Hébert ◽

Audrey Kern

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Psychological Distress ◽

Sexually Abused ◽

Maternal Mental Health ◽

Ptsd Symptoms ◽

Abused Children ◽

Maternal History ◽

History Of ◽

Sexually Abused Children

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children’s internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers’ self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children’s functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children’s disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children’s maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child’s disclosure and with their own traumatic past.

Download Full-text

Experiences of mothers of sexually abused children in North-West province, post disclosure

Curationis ◽

10.4102/curationis.v39i1.1659 ◽

2016 ◽

Vol 39 (1) ◽

Cited By ~ 4

Author(s):

Gaboipolelwe M. Masilo ◽

Mashudu Davhana-Maselesele

Keyword(s):

Sexual Abuse ◽

Sexually Abused ◽

Secondary Trauma ◽

Emotional Pain ◽

Abused Children ◽

North West ◽

South African Police Service ◽

The North ◽

North West Province ◽

Sexually Abused Children

Background: Sexual violence against children is increasing at an alarming rate in South Africa. In 2010 the South African Police Service (SAPS) reported 21 538 rape cases of children under 18 years. In the North-West province (NWP) 5039 incidents of rape cases were reported in 2009. Mothers often experience emotional pain following child sexual abuse disclosure. It is seldom acknowledged that these mothers experience trauma and need support, post disclosure. The researcher has no known evidence of research conducted on the experiences of these mothers in NWP. Objective: The objective of the study was to explore and describe the experiences of mothers of sexually abused children post disclosure of the abuse. Method: The research design was qualitative, exploratory, descriptive and contextual. Purposive sampling was used to select mothers of sexually abused children aged 23 to 59 years whose children ranged from 0 to 16 years. Permission to conduct the study was sought from the Provincial Department of Health and informed consent was obtained from the mothers. Interviews were conducted with a sample of n = 17 until data saturation. Data were collected through in-depth interviews using a voice recorder and field notes to enhance triangulation. Tesch’s method of open coding was used to analyse data. Results: Findings indicated that mothers experienced emotional pain post sexual abuse. They expressed shock, anger and guilt for not noticing the abuse. They showed significant depression as a result of lack of support by stakeholders. Conclusion: Mothers experienced secondary trauma that poses social and psychological challenges with far-reaching implications.

Download Full-text

Sexual Abuse of Children: Implications for Practice

Social Casework ◽

10.1177/104438948106201004 ◽

1981 ◽

Vol 62 (10) ◽

pp. 601-606 ◽

Cited By ~ 45

Author(s):

Jon R. Conte ◽

Lucy Berliner

Keyword(s):

Sexual Abuse ◽

Social Work ◽

Sexually Abused ◽

Sex Offender ◽

Descriptive Data ◽

Abused Children ◽

Sexually Abused Children

Descriptive data on sexually abused children confirm that most children are abused by members or acquaintances of their own families. Social work services for victims should include efforts to protect the child from further abuse, and insure that the child, non-abusing parent, and sex offender receive services.

Download Full-text