Search

Resume La presence de comportements sexuels problematiques (CSP) chez les enfants se manifeste souvent en parallele a plusieurs difficultes d’adaptation dans les spheres sociales, emotionnelles et comportementales. Toutefois, bien que la plupart des interventions specialisees en la matiere documente une reduction des CSP en cours de therapie, peu d’etudes ont mesure l’evolution des difficultes qui se manifestent dans les autres spheres d’adaptation de ces enfants. Objectifs La presente etude vise donc a : (1) decrire le profil psychosocial des enfants pris en charge dans un contexte therapeutique (2) evaluer l’evolution de l’ensemble de ces dimensions ciblees par la therapie. Methode L’echantillon est constitue de 51 dyades parents–enfants (enfants : M = 8,86 ans ; E-T = 2,20) debutant une psychotherapie centree sur les CSP d’approche cognitive comportementale et impliquant la participation d’une figure parentale, offerte a la suite d’une evaluation par un centre specialise. Un devis a deux temps de mesure (pretest et post-test) a ete utilise. Resultats Bien que le profil psychosocial de ces enfants s’avere heterogene, plusieurs sont confrontes a des defis importants (p. ex. victimisations, placements, troubles de comportements). Les resultats revelent des ameliorations significatives sur le plan des comportements sexuels qui sont parmi les plus problematiques. Les parents observent aussi une amelioration quant aux problemes interiorises et exteriorises, ainsi que sur le plan des symptomes de dissociation. Conclusion Cette etude permet d’avoir une vision plus holistique des difficultes auxquelles les enfants sont confrontes et de leur evolution en therapie et reflete la pertinence des interventions specialisees et individualisees.

Child sexual abuse is an important public health issue given its magnitude and the multiple associated consequences. The diversity of profiles in child victims of sexual abuse calls for a more personalized approach to treatment. Indeed, recent studies suggest that children display a variety of symptoms and that a subgroup of sexually abused children may present a profile of complex trauma. This article first presents a review of the scientific literature that positions Trauma-Focused Cognitive Behavioural Therapy (TF-CBT; Cohen et al., 2017) amongst the best practices to address trauma-related symptoms following child sexual abuse; whether it is co-occurring with other forms of violence or not. Various adaptations of TF-CBT therapy are proposed by the authors (Cohen et al., 2012) to treat children facing complex trauma. These adaptations are summarized and illustrated with the presentation of a clinical case involving two siblings from the same family.

Little is known about the development of childhood sexual behavior problems (SBP) in terms of continuity and discontinuity into adolescence. Prior studies have espoused a nondevelopmental approach focusing on the clinical profiles of these youths at the time of their referral. To address this gap, the current study proposes an examination of the developmental covariates involved in the continuity of SBP among a sample of 340 children and adolescents referred to Child Protection Services (CPS) in Quebec, Canada. Children’s CPS contacts from birth up to age 17 were inspected, allowing to recreate the life history of social and familial adversities during that period. Logistic regression models were performed and helped to identify developmental covariates of childhood-onset SBP and its persistence into adolescence. Findings suggest that children with childhood-onset SBP that persisted into adolescence have experienced various life adversities. The study findings provide some preliminary evidence of the developmental pathways of SBP.

Victims of child sexual abuse (CSA) are likely to show a wide range of adaptation difficulties. In addition, some children and their families are involved in legal proceedings following the child’s disclosure. However, little is known about the effects of legal involvement on CSA victim’s mental health and recovery. In this longitudinal study, the effects of testifying were examined in a sample of 344 children at initial assessment (67% of girls) receiving services in a Child Advocacy Centre, of which 130 children testified. The participants’ age ranged from 6 to 14 years old (M = 9.42 SD = 2.14). Children and their parents completed a series of measures to evaluate the child’s mental health (e.g. depression, anxiety, PTSD) at four points in time over a 2-year period. Multilevel analysis indicates that all the children showed significant improvement over time but the group who testified more than once shows higher levels of emotional distress 2 years after the initial assessment. This study highlights the importance of documenting the experience of CSA victims in the justice system in order to establish the adequate conditions to support child witnesses.

Le but de l’article est de presenter les resultats d’un consortium d’experts designes par le Centre d’expertise Marie-Vincent. Le mandat du consortium etait d’evaluer l’etat des connaissances sur l...

Background Sexual behavior problems (SBP) in school-aged children is a social concern that draws increased attention amongst child protection services and practitioners. Past research that highlighted the variety in profiles and in behavioral manifestations of children with SBP emphasizes the importance of a well-informed and sensitive approach for appropriate intervention. However, studies validating the theoretically hypothesized vulnerability of children with SBP remains scarce. Objective This study aimed to further our understanding of the risk factors that influence the variety and severity of SBP. Participants and setting Eighty-eight child-adult dyads (35.2% girls, Mage = 9.1 years; SD = 2.2 years) referred for SBP by child protection services or public services between 2006 and 2010 participated in the study. Participants completed a series of questionnaires as part of their assessment in a specialized therapeutic center for SBP. Methods A theoretical model of risk factors was examined using multiple linear regression analysis. Results Amongst the factors identified, externalizing behavior problems were the most strongly associated with the variety (β = .50; p Conclusions This study outlines the high co-occurrence of SBP, externalizing behaviors and non-sexual victimization, which should raise concern for the assessment of the children and to further adapt treatment strategies and goals.

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents’ adaptation to their child’s unveiling of CSA deserves further attention. Parents’ history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child’s abuse disclosure. This study proposes a mediation model that explores various processes underlying mother’s psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children’s unveiling of CSA. It investigates the influence of mother’s own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child’s CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother’s exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother’s psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.

Summary Symptoms of preschoolers following sexual abuse are not as well documented as for other age groups. This is true both in terms of the associated consequences as well as treatment outcomes. This limitation may be related to the fact that preschoolers represent a subgroup for which it is particularly challenging to substantiate sexual abuse allegations. Younger children also represent a challenge in intervention due to their level of cognitive development and their limited ability to comprehend such complex topics, such as sexuality. Assessing the effects of interventions with this subgroup of children therefore represents a priority in the field. The aim of this paper is to discuss the challenges inherent to the implementation of a cognitive behavioural treatment, namely the Trauma-Focused-Cognitive Behavioural Therapy (TF-CBT; Cohen et al., 2006) with sexually abused preschoolers and to present the results of a pilot study assessing it's effects with a sample of 25 children. Results reveal positive outcomes related to treatment participation both in children and in their accompanying parent. Preschoolers have demonstrated a significant decrease in internalised and externalised behaviour problems as well as a decrease in dissociation symptoms. A significant decrease in psychological distress and post-traumatic stress symptoms was also observed in children's parents following therapy. A follow-up assessment conducted 1 year following the initial assessment revealed that therapeutic gains were maintained over time. Clinical experience highlights specific challenges with preschoolers that are discussed in terms of treatment adaptation.

Resume Les symptomes des enfants d’âge prescolaire, suite a une agression sexuelle, ne sont pas aussi bien documentes que pour d’autres groupes d’âges. Notre comprehension de leur experience est limitee tant sur le plan des consequences associees a l’agression sexuelle qu’en termes d’efficacite des interventions. Cette limite s’explique en partie par le fait que ces enfants representent un sous-groupe pour lequel il est particulierement ardu de valider les allegations d’agression sexuelle. D’autres limites sur le plan du developpement cognitif et de la comprehension de sujets complexes tels que la sexualite representent egalement des defis importants. L’evaluation des interventions aupres de ce sous-groupe se doit donc d’etre une priorite dans le domaine. L’objectif de cet article est de discuter des enjeux lies a l’application d’une approche cognitivo-comportementale soit la Trauma-Focused Cognitive Behavioral Therapy (TF-CBT ; Cohen et al., 2006) aupres des enfants d’âge prescolaire victimes d’agression sexuelle et de presenter les resultats d’une etude pilote realisee aupres d’un echantillon de 25 enfants. Les resultats obtenus temoignent d’effets positifs lies a la participation a la TF-CBT tant chez les enfants que chez les parents. Ainsi, les difficultes de comportements interiorises et exteriorises de meme que les symptomes de dissociation des enfants diminuent apres les seances de therapie. Nous avons egalement observe une reduction significative de la detresse psychologique et des symptomes de stress post-traumatique chez les parents. Une relance realisee un an apres l’evaluation initiale revele que les gains therapeutiques se maintiennent a travers le temps. L’experience clinique souleve des enjeux propres a l’intervention aupres des jeunes d’âge prescolaire qui sont discutes.

The purpose of this study was to explore factors influencing the academic, cognitive, and social functioning of 50 Canadian French-speaking sexually abused girls (age 7 to 12 years). Contextual, personal, and family factors characterizing the environment of children postdisclosure were examined as potential predictors of outcomes 1 year later. The severity and duration of the abuse, exposure to other forms of victimization, and symptoms of dissociation were associated with outcomes over time in one or more of the three domains assessed. Personal variables were also identified as important protective factors, including younger age at disclosure, greater use of approach coping strategies, and children's involvement in structured extracurricular activities. Results are discussed in terms of clinical implications.

(2007). The French-Canadian Version of the elf-Report Coping calc:Estimates of the Reliability, Validity, and Development of a Short Form. Measurement and Evaluation in Counseling and Development: Vol. 40, No. 1, pp. 4-15.

A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.

The present study attempted to identify individual and contextual factors associated with outcomes in a group of 63 latency-aged children disclosing sexual abuse (SA). Children reporting SA were found to display greater internalizing and externalizing behavioral difficulties as well as more sexualized behaviors relative to same-age non-abused peers. Mothers also reported these children as less socially competent than their peers. Family contextual factors appeared to be associated with behavioral difficulties and made a unique contribution to the prediction of externalizing and sexualized behaviors. Of the personal variables, avoidance coping was found to be linked to poorer outcomes. In examining possible factors linked to ‘resilient’ outcomes in a 6-month time-frame, family conflict and avoidance coping were found to be associated to clinical status in children reporting SA.

OBJECTIVES: The short-term outcomes of child sexual abuse (CSA) on academic, behavioral and social adaptation at school were examined in order to: (1) document the proportion of sexually abused (SA) girls struggling in school and define the nature of their difficulties, (2) explore whether different profiles of school adaptation could be identified, and (3) examine the different constellations of contextual, personal, and familial correlates of abuse for each profile. METHOD: The sample consisted of 100 French-speaking mother-daughter dyads. Girls (aged 7-12, M= 8.64) were administered cognitive functioning tests and completed self-report measures to assess symptomatology, perception of abuse, and support provided. Mothers and teachers completed questionnaires to assess child's emotional, social, behavioral, and academic functioning in school. RESULTS: Descriptive analyses showed that a substantial number of girls (54%) presented clinical school adaptation difficulties in at least one of the three domains evaluated. Cluster analysis revealed four distinctive school functioning profiles: (1) academic-specific, (2) acting out/withdrawn, (3) polyclinical, and (4) resilient. These were distinguished by degree of school functioning difficulties and number of domains affected. The profiles were further discriminated by elements of the CSA experience and contextual, familial, and personal factors. The number of spheres of functioning affected was proportional to the number of risk factors to which girls were exposed. DISCUSSION: Results suggest the need for a systematic and thorough assessment of SA child functioning at school and may guide mental health professionals in providing differential treatment on the basis of the emerged typology. PRACTICE IMPLICATIONS: Sexually abused children demonstrate a wide variability of responses, rendering the elaboration of a "one size fits all" treatment rather difficult. The emerged typology underscores the complex heterogeneity of school adjustment profiles and suggest that secondary effects of abuse on child's level of school functioning require specific assessment and close monitoring. This study raises practical questions as to whether such secondary effects could best be addressed as a primary treatment objective, or in addition to a trauma-focused approach, or as the sole treatment objective. Language: en

Au Québec, les jeunes faisant l’objet d’un double mandat sont ceux suivis en vertu de la Loi sur le système de justice pénale pour adolescents (LSJPA) et ayant vécu à un moment de leur vie une prise en charge en vertu de la Loi sur la protection de la jeunesse (LPJ). Parmi l’ensemble de la clientèle desservie par les Centres Jeunesse (CJ), ces jeunes sont considérés comme les plus vulnérables et sont à risque de récidive. À l’aide d’analyses descriptives et comparatives, cet article brosse un portrait des trajectoires de services, de l’enfance à l’adolescence, de 15 851 jeunes faisant l’objet d’un double mandat. Il détaille la chronologie de leur prise en charge et met en lumière l’enjeu de l’intervention concomittante. Les résultats ont révélé quatre parcours principaux qui se différencient quant à l’historique de victimisation et de délinquance de ces jeunes. Le parcours nommé Entrée LPJ et chevauchement de la LSJPA se distingue comme étant le plus emprunté, et celui marqué par le plus haut taux d’infraction et de récidive. Le parcours nommé Entrée LPJ et inclusion LSJPA se distingue par des taux de victimisation particulièrement élevés et une plus grande instabilité dans les placements; et des taux de judiciarisation moins élevés. Les implications pour l’intervention offerte en CJ, notamment sous l’angle de la coordination des systèmes de protection et de justice juvénile, sont discutées., In Quebec, crossover youth refer to those who are monitored under the Youth Criminal Justice Act (YCJA) and have, at some point in their life, been under the care of the Youth Protection Act (YPA). Among the population served by Youth Centres (YCs), these young people are considered most vulnerable and are at risk of re-offending. Using descriptive and comparative analyses, this article presents an overview of the service trajectories of 15,851 crossover youth, from childhood through adolescence. It provides a detailed chronology of their care history and services they received under both Acts and highlights the issue of concurrent intervention. The results reveal four main trajectories that differ in terms of history of victimization and delinquency. The trajectory named child protection entry and YCJA overlap is the most frequent service trajectory; but is also one that is marked by the highest rates of infraction and recidivism. The trajectory called child protection entry and YCJA inclusion is composed of youth with the highest rates of reported maltreatment and the highest rates of placement instability but lower rates of recidivism. The implications for intervention in YCs, particularly in terms of coordinating juvenile justice and protection systems, are discussed.

L’agression sexuelle pendant l’enfance peut être un événement traumatique pour l’enfant et les membres de sa famille. Il s’agit d’un acte criminel qui nécessite des mesures d’évaluation, d’intervention et souvent de protection immédiate. Dans certains cas, ces mesures donneront lieu à des procédures légales. Bien que nous ayons une connaissance de plus en plus approfondie des conséquences associées à l’agression sexuelle et des interventions thérapeutiques efficaces, nous en savons peu sur l’influence des procédures judiciaires sur le rétablissement des enfants. Cette étude analyse les différentes trajectoires judiciaires d’enfants victimes d’agression sexuelle et leur influence sur la santé mentale des enfants ayant bénéficié d’une psychothérapie dans un centre d’appui aux enfants (CAE). Les résultats indiquent que pour près du tiers des enfants (28 %), des procédures légales allant jusqu’au témoignage à la cour ont été entreprises, le plus souvent, avant la psychothérapie. Les résultats révèlent que dans certaines circonstances, les implications judiciaires ont un effet bénéfique sur le bien-être des enfants. On observe des gains thérapeutiques plus importants chez les enfants qui ont témoigné à la cour et chez ceux pour qui il y a eu des procédures judiciaires, que pour ceux pour qui il n’y a pas eu d’implication légale. Ces résultats initiaux soulignent l’importance de mieux documenter le volet judiciaire et contribuent à définir les conditions favorisant un meilleur rétablissement chez les enfants victimes d’agression sexuelle., Sexual abuse during childhood can be traumatic for children and their families. The criminal aspect of this form of victimization requires specialized evaluations, interventions, and, often, immediate measures to ensure the child’s protection. In some cases, these lead to legal procedures. Although our knowledge regarding the consequences of child sexual abuse and effective therapeutic interventions continues to increase, we know little of the impact of legal procedures on these children’s rehabilitation. This study examines the various judiciary trajectories followed by sexually abused children and their influence on the mental health of children receiving therapeutic services in a Child Advocacy Center (CAC). Results show that about a third of the children (28 %) were involved in legal actions, sometimes including a court appearance, usually before therapy began. Our findings indicate that in some circumstances legal activities had beneficial effects on the children’s mental health. We observed greater therapeutic gains in children who testified in court and in children for whom legal procedures were undertaken than in children for whom no legal actions were taken. These initial findings underline the need for better documentation of the judicial component of such children’s experience and can help identify conditions that facilitate recovery in sexually abused children., La agresión sexual durante la infancia puede ser un evento traumático para el niño y los miembros de su familia. Consiste en un acto criminal que precisa de medidas de evaluación, de intervención y, a menudo, de protección inmediata. En ciertos casos, dichas medidas darán lugar a procesos judiciales. Si bien nuestro conocimiento sobre las consecuencias asociadas a la agresión sexual y a los tratamientos terapéuticos eficaces es cada vez más profundo, poco sabemos sobre la influencia del proceso judicial sobre el restablecimiento de los niños. El presente artículo analiza las diferentes trayectorias judiciales de los niños víctimas de agresión sexual y de su influencia sobre la salud mental de aquéllos que obtuvieron una psicoterapia en un centro de ayuda a los niños. Los resultados indican que, para casi el tercio de los niños (28 %), se han realizado procedimientos judiciales, llegando incluso al testimonio en el tribunal, la mayoría de las veces antes que la psicoterapia. Los resultados revelan que, en ciertas circunstancias, las implicaciones judiciales tienen un efecto terapéutico sobre el bienestar de los niños. Se observan beneficios terapéuticos más importantes en los niños que han declarado en los tribunales y en aquéllos para los cuales se realizaron procesos judiciales que en aquéllos para los cuales no hubo implicación legal alguna. Estos resultados iniciales subrayan la importancia de documentar mejor el aspecto jurídico y contribuyen a definir las condiciones que favorezcan una mejor recuperación de los niños víctimas de agresión sexual.

L’acte de témoigner devant un tribunal peut être une épreuve extrêmement éprouvante et exigeante pour les enfants et adolescents victimes ou témoins d’actes criminels. Certains jeunes, notamment ceux pris en charge en vertu de la Loi sur la protection de la jeunesse (LPJ), ont des besoins particuliers et peuvent avoir à témoigner à plus d’une reprise. Alors que plusieurs enfants et adolescents sont appelés à témoigner, peu d’études ont permis de documenter l’apport des programmes de préparation au témoignage pour bien accompagner les jeunes. Au sein d’un échantillon de jeunes bénéficiant d’un programme de préparation au témoignage, cette étude vise à documenter leur expérience judiciaire et à évaluer l’apport du programme sur le niveau de craintes des témoins mineurs. Les résultats indiquent que les filles entretiennent plus de craintes que les garçons à l’idée de témoigner. Les résultats montrent que 44,1 % des jeunes qui ont été préparés au témoignage ont eu à livrer un témoignage. Une diminution significative du niveau de craintes autorapportées dans le Fears of Court Questionnaire (Centre for Children and Families in the Justice System, 2002) a été observée entre le pré-test et au terme de l’intervention. Ces résultats confirment l’importance de bien préparer les jeunes qui sont amenés à témoigner. D’autres études sont nécessaires pour documenter les autres retombées du programme., Testifying in court can be highly challenging and demanding for children and teenagers who witness or are victims of a crime. Certain young people, especially those in care under the Youth Protection Act (YPA), have specific needs and may need to testify on more than one occasion. Despite the number of children and young people being called to testify, few studies have documented the contribution of preparation programs to the proper support of youth at the judicial level. Focusing on a sample of youth benefiting from a court preparation program, this study documents their judicial experience and assesses the outcome of this preparation program, which aims to reduce youths’ fears and worries. The results indicate that girls are more fearful of testifying than boys. The results also show that 44.1 % of program participants who have been prepared to testify have had to testify in court, with a statistically significant decrease in self-reported fear levels being observed in the Fears of Court Questionnaire (Centre for Children and Families in the Justice System, 2002) between the pre-test and the end of the intervention. These findings highlight the importance of preparing youth who are asked to testify. Further research is needed to document the additional impacts of these programs., Declarar ante un tribunal puede ser extremadamente difícil y exigente para los niños y adolescentes que son testigos o víctimas de un delito. Algunos jóvenes, especialmente los que están bajo la Ley de Protección de la Juventud (LPJ), tienen necesidades específicas y pueden tener que testificar en más de una ocasión. Aunque muchos niños y jóvenes víctimas son llamados a testificar, pocos estudios han documentado cuál es la contribución de los programas de preparación para testigos diseñados para acompañar mejor a estos jóvenes. Basándose en una muestra de jóvenes que participan en un programa de preparación judicial, este estudio documenta la experiencia judicial de estos jóvenes y evalúa la contribución del programa de preparación sobre los niveles de preocupación de los jóvenes. Los resultados indican que las chicas tienen más temores relacionados con la declaración que los chicos. Los resultados muestran que el 44,1 % de los participantes que estaban preparados para el testimonio tenían que dar testimonio. Se ha observado una disminución estadísticamente significativa de los niveles de preocupación autoinformados en el Cuestionario de Miedos a la Corte (Centro para Niños y Familias en el Sistema de Justicia, 2002) entre la prueba previa y el final de la intervención. Estos resultados ponen de relieve la importancia de preparar a los jóvenes a los que se les pide que testifiquen. Es necesario realizar más investigaciones para documentar otros resultados de estos programas.