==================================HSR33================================== 33. Trying to explore therapists' (social workers, psychologists, etc.) reactions (resistance, countertransference) to dealing with or uncovering childhood incestuous or sexually abusive experiences in their adult women clients. Adult victims of childhood incest who go into therapy and do not disclose the incident. Therapists often do not ask questions in their assessment or history taking that might reveal this. 1 UI - 87073678 AU - Solin CA TI - Displacement of affect in families following incest disclosure. AB - Long-standing intact families often decide to remain together following disclosure of incest. The defense of displacement, characteristically featured in these families, is discussed. The origins and ramifications of the defense are reviewed with emphasis on its highly reactive nature. Guidelines are suggested for a multidisciplinary treatment approach. MH - Adaptation, Psychological ; Adolescence ; Affect ; Child Abuse, Sexual/ PSYCHOLOGY ; Child Welfare ; Child ; *Displacement (Psychology) ; *Family ; Female ; Human ; *Incest ; Male ; Patient Care Team ; Professional-Patient Relations ; *Psychotherapy SO - Am J Orthopsychiatry 1986 Oct;56(4):570-6 2 UI - 87073677 AU - Bresee P ; Stearns GB ; Bess BH ; Packer LS TI - Allegations of child sexual abuse in child custody disputes: a therapeutic assessment model. AB - Guidelines are set forth for judges and others who must make decisions in custody disputes that include allegations of child sexual abuse. The focus is on the protection of the child and the model highlights the role of mental health professionals, prescribing separate therapists for child and parent where possible. Allegations of sexual abuse are seen as an indicator of emotional risk for the child, even in cases where the allegations are untrue. MH - Child Abuse, Sexual/*LEGISLATION & JURISPRUD. ; Child Welfare/LEGISLATION & JURISPRUD. ; Child ; Female ; Human ; Incest ; Interview, Psychological ; Male ; Models, Theoretical ; Mothers/PSYCHOLOGY ; Psychological Tests ; *Psychotherapy SO - Am J Orthopsychiatry 1986 Oct;56(4):560-9 3 UI - 87059809 AU - Coons PM TI - Treatment progress in 20 patients with multiple personality disorder. AB - Attempts to follow the treatment progress of patients with multiple personality have been limited to a few single case studies and, in the only large series, to those most successfully treated. This study followed the treatment progress of 20 patients for a mean of 39 months after intake. The study included a detailed history, neurological examination, and psychological testing on each patient. At follow-up each patient was interviewed and a questionnaire was completed by his or her therapist to assess treatment response. Although nine patients achieved partial or full integration, complete integration was maintained by only five. During therapy the unintegrated patients experienced emotional trauma at approximately twice the rate as did the patients who eventually became integrated. Psychodynamic psychotherapy and hypnosis were the most widely prescribed therapies. The improvement in multiple personality appeared to proceed in a stepwise fashion from acceptance of the diagnosis to integration. The progress of therapy was hindered most commonly by the overuse of the mental mechanisms of repression and denial, the continued utilization of secrecy, which began during child abuse, and the production of numerous crises. The most common countertransferences included anger, exasperation, and emotional exhaustion. Although the psychotherapy of patients with multiple personality is tedious and time consuming, it can be eminently successful if the patient and therapist persevere. MH - Adolescence ; Adult ; Art Therapy ; Attitude to Health ; Child Abuse/ PSYCHOLOGY ; Crisis Intervention ; Denial (Psychology) ; Female ; Human ; Hypnosis ; Incest ; Male ; Marital Therapy ; Middle Age ; Multiple-Personality Disorder/PSYCHOLOGY/*THERAPY ; Physician-Patient Relations ; Psychotherapy/*METHODS ; Repression SO - J Nerv Ment Dis 1986 Dec;174(12):715-21 4 UI - 86297695 AU - Jones DP TI - Individual psychotherapy for the sexually abused child. AB - This paper describes one Center's experience using individual psychotherapy to help the sexually abused child. The approach described rests upon a five-part conceptualization of the traumatic experience: trauma, threat to ontogeny, neglect and emotional unavailability by the caregiver, child's feeling of exploitation, and the child's adaptation. The process of treatment is divided into three phases: starting, middle and closing. Some common issues which occur are guilt, loss and anger, as well as alterations in the child's sexual feelings. The psychotherapeutic approach to these and other issues is coordinated with other therapies. If the child is to appear in court, the experience of testifying provides a reality-based focus for treatment and is not a divisive problem for the therapist. At times, therapists experience feelings of anger, hopelessness and a desire to rescue their patients. The therapists meeting in a supervision group provided a means of understanding and working through the therapists' experiences. Future study of the therapy process with long term follow-up could reveal the issues necessary for an abused child to negotiate in order to achieve full recovery. Further research could establish which treatment modality is primarily suited to a particular type of sexually abused child taking into account differences in age, duration and severity of abuse, family dynamics and psychological impact. MH - Adaptation, Psychological ; Adjustment Disorders/THERAPY ; Child ; *Child Abuse ; Child Behavior Disorders/THERAPY ; Child, Preschool ; Dissociative Disorders/THERAPY ; Family Therapy/METHODS ; Female ; Follow-Up Studies ; Gender Identity ; Human ; *Incest ; Male ; Professional-Patient Relations ; Psychotherapy/*METHODS SO - Child Abuse Negl 1986;10(3):377-85 5 UI - 86293224 AU - Rieker PP ; Carmen EH TI - The victim-to-patient process: the disconfirmation and transformation of abuse. AB - The victim-to-patient process is reconceptualized as an interplay among abuse events, family relationships, and other life contexts, emphasizing the fragmented identity deriving from accommodations to the judgments of others about the abuse. Original defenses are seen to form the later core of the survivor's psychopathology. This schema helps clinicians to understand obstacles to treatment and recovery and to recognize the behavior reflecting disconfirmation and transformation of abuse. MH - *Adaptation, Psychological ; Adolescence ; Adult ; Child ; *Child Abuse ; Family ; Female ; Follow-Up Studies ; Human ; Incest ; Male ; Mental Disorders/PSYCHOLOGY ; Personality Development ; Psychotherapy ; Self Concept ; *Sex Offenses ; Social Environment ; Violence SO - Am J Orthopsychiatry 1986 Jul;56(3):360-70 6 UI - 86266138 AU - Hazzard A ; King HE ; Webb C TI - Group therapy with sexually abused adolescent girls. AB - Clinical guidelines are presented for conducting group therapy with sexually abused adolescent girls, based on a literature review and the authors' clinical experience. Common treatment themes, pragmatic issues related to setting up a group treatment program, and group process issues are discussed. MH - Adolescence ; Assertiveness ; Child ; *Child Abuse/LEGISLATION & JURISPRUD. ; Defense Mechanisms ; Emotions ; Family ; Female ; Group Processes ; Guilt ; Human ; Incest ; Interpersonal Relations ; Psychotherapy, Group/*METHODS ; Self Concept ; Self Disclosure ; Sex Behavior ; *Sex Offenses/LEGISLATION & JURISPRUD. SO - Am J Psychother 1986 Apr;40(2):213-23 7 UI - 86226075 AU - Travin S ; Bluestone H ; Coleman E ; Cullen K ; Melella J TI - Pedophile types and treatment perspectives. AB - Pedophiles constitute a heterogeneous group of sex offenders. Direct physiological assessment of sexual arousal has significantly increased our diagnostic skill and capability of monitoring treatment response. Erectile response studies have indicated that the majority of pedophiles and incest offenders show arousal to other paraphilias and frequently to appropriate adult sexual stimuli. Many sexual offenders deny or minimize their problem during initial interviews, but when confronted with laboratory results indicating deviant sexual arousal, they often acknowledge and elaborate on the paraphilia(s). Complete data and diagnoses are crucial in integrating treatment in the cognitive-behavioral paradigm. MH - Adolescence ; Adult ; Behavior Therapy ; Case Report ; Child ; Dangerous Behavior ; Female ; Human ; Incest ; Male ; Manuals ; Paraphilias/ *DIAGNOSIS ; Pedophilia/*DIAGNOSIS/THERAPY ; Penile Erection ; Prognosis ; Psychological Tests SO - J Forensic Sci 1986 Apr;31(2):614-20 8 UI - 86148178 AU - Hansen M ; Young DA ; Carden FE TI - Psychological evaluation and support in the pediatric intensive care unit. AB - This article has discussed the role of the psychological consultant in the PICU. New advances in critical care treatment have created the need for a greater awareness of psychological issues that affect the medical management of children, and the emotional impact on their families. Psychological consultation can assist in clarifying and addressing these issues by identifying and evaluating the stressors impinging on the patient, and implementing or directing appropriate interventions. This intervention may also entail assistance to the family and care providers in coping with intense and emotionally sensitive issues. MH - Child ; Child Abuse ; Critical Care/*PSYCHOLOGY ; Family Therapy ; Female ; Human ; Incest ; Intensive Care Units/*MANPOWER ; Male ; Mental Disorders/*THERAPY ; Neoplasms/PSYCHOLOGY ; Nursing Staff, Hospital/ PSYCHOLOGY ; Parents/PSYCHOLOGY ; *Psychology, Clinical ; Psychotherapy SO - Pediatr Ann 1986 Jan;15(1):60-9 9 UI - 86139919 AU - Coons PM ; Milstein V TI - Psychosexual disturbances in multiple personality: characteristics, etiology, and treatment. AB - In a series of 20 patients with multiple personality, there was a 75% incidence of sexual abuse and a 55% incidence of physical abuse during childhood. Six of the 17 female patients (35%) had been raped in adolescence or adulthood. Patients were matched for age and sex with a nondissociative disorder control group. Although 55% of the multiple personality group had psychosexual disturbances, this was just barely significant when compared with the control group. Multiple personality appears to be an adaptive response to various traumata and enables the individual superficially to function sexually because sexual functioning is often dissociated and managed by an alternate personality. MH - Adolescence ; Adult ; Case Report ; Child ; Child Abuse ; Female ; Human ; Incest ; Male ; Middle Age ; Multiple-Personality Disorder/ *COMPLICATIONS/DIAGNOSIS/PSYCHOLOGY ; MMPI ; Psychosexual Disorders/ *DIAGNOSIS/ETIOLOGY/THERAPY ; Psychosexual Dysfunctions/DIAGNOSIS/ ETIOLOGY/PSYCHOLOGY ; Psychotherapy, Group ; Rape ; Sex Behavior SO - J Clin Psychiatry 1986 Mar;47(3):106-10 10 UI - 86139436 AU - Bernstein AE ; Severino SK TI - The "dumb spot: a special problem in countertransference. AB - A special kind of countertransference which we call the "dumb spot,: has been observed and described. We have delineated "dumb spots: which are the result of unlearned theory, the result of learned but not accepted theory, and the result of learned, accepted but not used theory. Those "dumb spots: resulting from unlearned theory, especially in those areas where psychoanalysis is widening its scope of diagnostic categories, age range, and socioeconomic status, are not considered countertransference errors. Those "dumb spots: resulting from learned, accepted but not used theory, we feel do represent special cases of countertransference phenomena. Theory which is learned but not accepted must be differentiated into that which is not accepted as a result of intellectual judgment and that which cannot be accepted because it would require an alteration in the analyst's self or object representations. MH - Adult ; Case Report ; *Countertransference (Psychology) ; Fees and Charges ; Female ; Human ; Incest ; Male ; Object Attachment ; *Psychoanalytic Theory ; Psychoanalytic Therapy ; Religion and Psychology ; Shame SO - J Am Acad Psychoanal 1986 Jan;14(1):85-94 11 UI - 86127634 AU - Long KA TI - Cultural considerations in the assessment and treatment of intrafamilial abuse. AB - Cultural and subcultural factors can have a marked impact upon reporting, assessment, and treatment of abuse and family violence. Values and beliefs associated with three specific rural situations--small towns, Native American reservations, and cliques of health professionals--are examined and case illustrations are presented. Recommendations are offered for refining assessment and treatment strategies in these settings. MH - Adolescence ; Adult ; Case Report ; Child ; Child Abuse/*PREVENTION & CONTROL ; *Cultural Characteristics ; *Culture ; *Family Therapy ; Female ; Human ; Incest ; Male ; Sex Offenses ; Spouse Abuse/*PREVENTION & CONTROL SO - Am J Orthopsychiatry 1986 Jan;56(1):131-6