Child Abuse Trauma Vol. 2 : Theory and Treatment of the Lasting Effects

by John N. Briere

• ISBN13: 9780803937130
• ISBN10: 080393713X
• Edition: 1st
• Format: Paperback
• Copyright: 1992-09-21
• Publisher: SAGE Publications, Inc

Summary

This volume considers the unique and overlapping long-term effects of all major forms of child maltreatment. The author integrates information on seven types of child abuse and neglect - ranging from sexual and physical abuse to mistreatment by alcoholic or drug-addicted parents - and outlines the complex ways in which abuse impacts on later psychosocial functioning.Briere reframes traditional notions of psychopathology and describes treatment approaches to abuse-related Post-Traumatic Stress Disorder, interpersonal dysfunction, self-destructive behaviour, impaired self-reference and borderline personality disorder. Child Abuse Trauma will be an invaluable resource for abuse specialists and for general therap

Table of Contents

Foreword	ix
Lucy Berliner
Preface	xii
David Finkelhor
Introduction	xvi
Acknowledgments	xx
Part I. Incidence of Child Abuse	1	(16)
Types and Forms of Child Maltreatment	3	(14)
Sexual Abuse	3	(3)
Physical Abuse	6	(2)
Psychological Abuse	8	(2)
Emotional Neglect	10	(2)
Parental Alcoholism and/or Drug Addiction	12	(3)
Other Forms of Abuse	15	(2)
Part II. The Long-Term Impacts of Child Abuse: Integration of Research and Theory	17	(62)
Long-Term Impacts of Child Abuse I: Psychological Responses	19	(29)
Posttraumatic Effects	19	(4)
Cognitive Distortions	23	(5)
The Development of Cognitive Distortions as a Result of Abuse	25	(3)
Altered Emotionality	28	(7)
Depression	29	(3)
Anxiety	32	(3)
Dissociation	35	(7)
Disengagement	37	(1)
Detachment/Numbing	38	(1)
Observation	38	(1)
Amnesia	39	(1)
Multiple Personality Disorder	40	(2)
Impaired Self-Reference	42	(6)
Long-Term Impacts of Child Abuse II: Behaviors and Relationships	48	(31)
Disturbed Relatedness	49	(9)
Intimacy Disturbance	50	(1)
Altered Sexuality	51	(2)
Assumptions Regarding Aggression in Relationships	53	(1)
Adversariality and ``Manipulation''	54	(3)
Aggression	57	(1)
Avoidance	58	(11)
Use of Psychoactive Substances	59	(2)
Suicidality	61	(1)
Tension-Reducing Behaviors	62	(7)
Abuse Effects as ``Codependence''	69	(4)
Abuse Effects as ``Borderline Personality Disorder''	73	(3)
Conclusions	76	(3)
Part III. Exploring the Solution: Abuse-Focused Psychotherapy	79	(86)
Philosophy of Treatment	81	(17)
Respect, Positive Regard, and the Assumption of Growth	81	(2)
The Phenomenological Perspective	83	(2)
Functionality of ``Symptoms'' and Defenses	85	(2)
Awareness and Integration	87	(2)
The Therapeutic Structure	89	(1)
Therapy as Reality Based	90	(3)
Social Context	93	(3)
Summary	96	(2)
Parameters of Treatment I: Process Issues	98	(14)
Assessment	99	(3)
Abuse History	100	(1)
Psychological State	101	(1)
Exploration Versus Consolidation	102	(1)
Intensity Control Within the Session	103	(1)
Time Focus	104	(1)
Addressing Client ``Resistance''	105	(1)
Sequence of Therapeutic Goals	106	(2)
Termination Issues	108	(3)
Preparation for Termination	110	(1)
Restimulated Trauma, Loss, and Abandonment Issues	110	(1)
Fears of Posttreatment Regression	110	(1)
Summary	111	(1)
Parameters of Treatment II: Intervention Approaches	112	(30)
Intervening in Impaired Self-Reference	113	(9)
Safety and Support in the Therapeutic Relationship	114	(1)
Therapist Feedback	115	(1)
Working Through Dependence and Boundary Confusion in the Therapeutic Relationship	116	(2)
Self-Support Techniques	118	(2)
Building Affect-Regulation Skills	120	(2)
Cognitive Interventions	122	(7)
The Cognitive Approach to Abuse Trauma	123	(6)
Exploration and Desensitization of Trauma	129	(12)
Exploration of Memories	131	(5)
Emotional Processing	136	(4)
Work in Absentia	140	(1)
Summary	141	(1)
Special Issues in Abuse-Focused Therapy	142	(23)
Treatment-Based Exacerbation of Symptoms	143	(2)
Substance-Addicted Survivors	145	(4)
The Amnestic Abuse Survivor	149	(3)
Hospitalization	152	(3)
Client Gender and Abuse Trauma	155	(3)
Abuse-Related Countertransference: The Therapist Survivor	158	(5)
Overidentification	159	(1)
Projection	159	(1)
Boundary Confusion	160	(1)
Addressing Abuse-Related Countertransference	161	(2)
Summary	163	(2)
Appendix: The Child Maltreatment Interview Schedule	165	(13)
References	178	(14)
Index	192	(11)
About the Author	203