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OBJECTIVE: The goal was to develop an empirically derived typology for sexually abused children exhibiting sexual behavior problems to assist practitioners in differential assessment, treatment, and case planning. METHOD: Data were systematically gathered from the clinical records of 100 sexually abused children, aged 3 years to 7 years, enrolled in two treatment programs. Twelve indexes were created corresponding to major areas of child and family history, functioning, and treatment response. After initial sorting into subgroups based on the presence or absence of interpersonal sexual behavior problems, further subdivision was based on hierarchical cluster analysis. RESULTS: Five distinctive sexual behavior profiles emerged: (1) developmentally expected; and developmentally problematic (2) interpersonal, unplanned, (3) self-focused, (4) interpersonal, planned (noncoercive), and (5) interpersonal, planned (coercive). Elements of the child's sexual abuse experience, opportunities to learn/practice problematic sexual behavior, and familial variables best differentiated between the types. CONCLUSIONS: The five types differed not only in child sexual behavior but in most areas of child and family functioning, including treatment outcome. The findings offer support for the development of an empirically-based typology for children with sexual behavior problems utilizing a range of variables which go beyond typical classification systems based on offender and victim characteristics. 相似文献
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This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health needs of participants, contextual (culture, religion, economic and social) considerations and the adoption of holistic approach to sexuality education. Lack of open communication about sexual health matters between young people and adults; concerns that sexual health education could encourage sexual activity; and inadequate funding, were key barriers. Implementation was facilitated by the involvement of relevant stakeholders, the training of facilitators and adopting strategies to overcome resistance to sexual health education. The provision of structured, detailed lessons plans and monitoring with supportive supervision optimised fidelity of delivery. Barriers to implementation included facilitators’ resistance to teaching safe sex promotion and logistical challenges in school environments. Participants also reported that the validity of self-reported adolescent sexual behaviour (as part of evaluation) may be improved by complementing well-designed self-report surveys with computerised audio devices for data collection, qualitative interviews and participant observation. Study findings generate recommendations to improve future forms of school-based sexual health education in sub-Saharan Africa. 相似文献