A structured play therapy intervention model to mitigate the effects of childhood sexual abuse

PhD (Social Work), North-West University, Potchefstroom Campus, 2015The goal of the study is to develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse. South Africa has one of the highest prevalence rates for child sexual abuse, and professionals working with children are consequently faced with the phenomenon on an increasing scale. Many professionals find themselves ill-equipped to address the effect of sexual abuse on the child, and the lack of an integrated understanding of the phenomenon seems to exacerbate this need. In order to effectively address the effect of sexual abuse on the child, professionals need a holistic understanding of this phenomenon and its effects, as well as a clear outline of the necessary interventions. The thesis consists of five sections, which can be outlined as follows: Section A consists of the problem statement, the research questions, the research objective, the general theoretical assumption and the theoretical approach. It includes the research methodology, the limitations of the research, definitions of the key terms and the selection and structure of the dissertation. The research focused on the following specific objectives stemming from the problem statement: * To conduct a thorough literature study on various aspects pertaining to childhood sexual abuse in order to form a holistic, well-researched perspective on the phenomenon of childhood sexual abuse and the available evidence-based interventions in the sexual abuse of children; * To develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse; * To subject the prototype of the proposed intervention model to peer review in order to determine its strengths and weaknesses and make the necessary adaptations to the model prior to its final dissemination. Section B consists of four articles, in which the goals of the research, the outcomes of the literature study and the empirical study are reported. Each article is dealt with as a self-contained unit focusing on a specific aspect of the research and contributing to the collection of data necessary for the design and evaluation of the proposed intervention model. Article 1 Knowledge of the legislation pertaining to sexual abuse is imperative for health care professionals working with a child who has been sexually abused. This article provides a critical analysis of those aspects of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007, relevant to the health care professional. The shortcomings of the Act and the practical implications of these for healthcare professionals is pointed out. Focus also falls on the relevant sections of the Childcare Act, 38 of 2005 and how these sections complement the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007). Article 2 In order to effectively help traumatised children to achieve positive outcomes, professionals must have a clearly-defined methodology, underpinned by theory and based on an integrated approach. The first step towards this is clearly to redefine the phenomenon of child sexual abuse. As sexual abuse is both a legal and a psychosocial phenomenon, the authors are of the opinion that a more integrative definition is necessary in the South African context. The information in this article therefore aims to provide health care professionals with an integrative definition that takes into account both the South African legal definition of sexual abuse and the underlying psychosocial factors associated with it.Article 3 Sexual abuse is a phenomenon with far-reaching effects. This article provides a holistic look at the effects of sexual abuse from an ecological systems perspective. The effect of sexual abuse on the child as the focus of the microsystems is emphasized, as well as the effects on the parents or the child’s caregiver as the mesosystem. The article further considers the interactive dynamics between the different systems and explains how each system can contribute to either mitigating or exacerbating the effects of abuse on the child. Article 4 The research goal of this article is to develop and evaluate a structured play therapy intervention model to mitigate the effects of child sexual abuse. The intervention model was developed from the results of the previous articles as well as an in-depth literature study on existing therapeutic interventions. To fulfil the aim of this article, the following objectives are set: * To give an outline of the research * Methodology underlying the study; * To discuss the problem analysis and project plan; * To outline the intervention model for mitigating the effects of child sexual abuse; * To discuss the research findings on the proposed model. Section C gives a summary of the most important findings and conclusions regarding the research in general. It also contains recommendations and points to the contribution made to the specific field of study. Section D consists of the addenda to the research report, for example, the different instruments of measurement and the questionnaires. Section E concludes the thesis with summarized references.Doctora